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Feasibility of three-dimensional optical coherence tomography and optical Doppler tomography of malignancy in hamster cheek pouches.

OBJECTIVE: Hamster cheek pouches (HCP) with various degrees of 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced dysplasia and malignancies were imaged with OCT/ODT in vivo and in vitro to assess the potential for three-dimensional high-resolution optical localization of airway malignancy. BACKGROUND DATA: Optical coherence tomography (OCT)/optical doppler tomography (ODT) provide potential capability for real-time in vivo high-resolution (2-20 microm) cross-sectional imaging of tissues and spatially resolved blood flow in microvasculature for pathology diagnostics. METHODS: DMBA was applied to the right side of the cheek pouch (HCP), and mineral oil (control) to the left side three times weekly for 10-18 weeks in Syrian Golden Hamsters using a standard protocol for malignancy induction. HCP were imaged in vivo with OCT/ODT as well as in vitro post-excision, using a prototype 1310-nm broadband superluminescent diode-based OCT/ODT device constructed in our laboratory. Three-dimensional images were constructed, and compared to standard and three-dimensional histology hematoxylin and eosin staining. RESULTS AND CONCLUSION: OCT imaging offered exceptional resolution of the HCP to depths of 1-2 mm and confirmed ability to detect dysplasia and malignancy. Three-dimensional OCT images were readily constructed, allowing visualization of extent and localization of tumor margins. ODT demonstrated increased vascularity in the area of neoplasia. OCT/ODT is a promising new technology for oral airway diagnostics.

Animals↗

Surgical management of lower-lid basal cell carcinoma involving the medial canthus: a modification of the Mustarde cheek rotation flap.

The Mustarde cheek rotation flap has proved to be an extremely successful and reliable technique for repairing large defects of the lower lid. However, when a stump of normal, lash-bearing lid margin remains on the advancing edge of the flap, it does not seem appropriate to insert it into a defect that extends more medially than the position of the lower punctum. The lid margin must either be sacrificed or tissue brought in from the medial side to meet it. To resolve this problem, we have devised a modification, which involves utilizing the triangle of tissue lying below the defect to fill the gap medial to the position of the punctum. The maneuver has proved successful and has now been used on two occasions with satisfactory cosmetic and functional results. In this original descriptions of the cheek rotation flap, Mustarde sacrificed the triangle of skin below the excision defect. However, if a triangular portion is saved, based on the upper part of the advancing edge of the flap, this may be used to fill a medial defect, obviating the need to import tissue from elsewhere.

Aged↗

Estimating total body water in children on the basis of height and weight: a reevaluation of the formulas of Mellits and Cheek.

An estimate of total body water (TBW) has important implications in clinical practice. For patients on peritoneal dialysis (PD), the estimate is critical when determining the delivered dialysis dose. The formulas of Mellits and Cheek have been recommended to estimate TBW in children on PD. These formulas were derived from healthy children, and very few infants were included. To assess the accuracy of these formulas, the original data were obtained and additional data from a broad literature review were compiled. The majority of the new data points were in the infant age range. Data were fitted using least-squares methodology and backward elimination to obtain a parsimonious model. Best fits were obtained using age, gender, and weight or a height x weight term. The results of the curves are as follows: Infants 0 to 3 mo (n= 71): TBW = 0.887 x (Wt)(0.83) Children 3 mo to 13 yr(n = 167): TBW = 0.0846 x 0.95([if female]) x (Ht xWt)(0.65) Children > 13 yr (n = 99): TBW = 0.0758 x 0.84([if female]) x (Ht x Wt)(0.69) When compared with the previous Mellits and Cheek formulas, the new formula fits better for infants (comparison of prediction errors, P < 0.0004). These newer formulas do not perform significantly better for the older two groups. Actual TBW measurement in children on PD must still be determined to verify the use of these formulas and to accurately assess dialysis delivery and adequacy.

Body Height↗

The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation.

Resetting of the septum orbitale over the orbital rim, or "septal reset," is the latest step in achieving periorbital rejuvenation in composite rhytidectomy. The first significant step was the addition of orbicularis repositioning to conventional lateral vector deep plane rhytidectomy, followed by orbital fat preservation using the arcus marginalis release and fat transposition over the orbital rim. Those early procedures have been further refined to include the zygomaticus muscles with the orbicularis oculi in the composite flap, or zygorbicular cheek flap, and a septal reset. The septum orbitale reset has distinct advantages over transposition of orbital fat alone, as it creates a firmer undersurface for the lower eyelid. This maneuver will create a truly youthful lower eyelid-cheek complex, as the normal concave aging skeletonization of the periorbit is transformed to a convex contour of youth. The effectiveness of this operation can be demonstrated in most variations of human anatomy, whether congenital or iatrogenic, allowing the plastic surgeon to utilize the septal reset in virtually every patient undergoing and desiring a harmonious facial rejuvenation.

Adipose Tissue↗

The effect of turpentine on hamster cheek pouch mucosa: a model of epithelial hyperplasia and hyperkeratosis.

Hamster cheek pouches were painted thrice weekly with 50% v/v turpentine in liquid paraffin over periods ranging from 1 day to 16 weeks. Pouch mucosa was examined histologically for changes and measurements of epithelial thickness were made with a calibrated eyepiece micrometer. An increase in epithelial thickness was first observed 48 hrs. after a single painting and was accompanied by inflammatory changes in both epithelium and connective tissue. Maximal epithelial thickening occurred after 9 weeks of thrice weekly painting. Cheek pouches of animals left without further treatment for up to 1 year following 9 weeks painting were indistinguishable from controls. The epithelial response to treatment with turpentine is that of a reversible benign epithelial hyperplasia with hyperkeratosis.

Animals↗

Alterations in the volume of the intercellular space between epithelial cells of the hamster cheek-pouch: quantitative studies of normal and carcinogen-treated tissues.

The present report investigated the extent of the epithelial dysplastic feature known as "loss of cellular adherence" at the ultrastructural level by quantifying the volume of the intercellular space during hamster cheek-pouch carcinogenesis. Following topical application of DMBA to cheek-pouches, lesions were classified as hyperplasia, dysplasia and carcinoma, with untreated pouches serving as a control. Stereological point counting procedures were used to determine the volume density of intercellular space in defined basal, spinous and granular layers for each group. In general, progressive increases in volume density were detected within each stratum during carcinogenesis. These results indicate that increasing separation of epithelial cells occurs during carcinogenesis, although it is not yet known whether this results from loss of cohesion between specialised (i.e., desmosomal) or nonspecialised membrane areas. In addition, a simple indicator of pathological alteration, the Pathological Alteration Ratio (PAR), is described and was used to evaluate existing published data for intercellular spaces in various oral mucosal conditions. Values of the PAR were found to be substantially higher in carcinogen-treated epithelia than in reports describing changes in wound healing, lichen planus and leukoplakia simplex. These objective techniques are of value for investigating the pathogenesis of diseased epithelium and may find applications in the diagnosis of oral premalignant lesions.

9,10-Dimethyl-1,2-benzanthracene↗

Changes in cytokeratins following treatment of hamster cheek pouch epithelia with hyperplastic or neoplastic agents.

The effects of four different hyperplastic agents and of the carcinogen DMBA on cytokeratin expression in hamster cheek pouch epithelia were compared. Reversible hyperplasia was produced by the application of either oil of turpentine, vitamin A or TPA. No hyperplastic changes were produced by application of EPP. Apart from the transient appearance of a 45 kDa cytokeratin in one group treated with vitamin A, the immunohistochemical staining patterns and immunoblot profiles of cytokeratins from cheek pouches treated with each of the hyperplastic agents were identical to controls. Following application of DMBA, the cytokeratins stained with increased intensity in the spinous and granular cell layers. This was associated with increased amounts of 42-56 kDa cytokeratins and decreased production of 62-75 kDa cytokeratins. Monoclonal antibody AE1 detected a 45 kDa cytokeratin in extracts of DMBA-treated epithelia that was not detected in untreated epithelial extracts. Monoclonal antibody AE3 detected an additional 54 kDa cytokeratin band in extracts of DMBA-treated epithelia. These cytokeratin changes were present in preneoplastic epithelia and maintained in neoplastic epithelia.

9,10-Dimethyl-1,2-benzanthracene↗

Ploidy analysis of field cancerization and cancer development in the hamster cheek pouch carcinogenesis model.

BACKGROUND: The hamster cheek-pouch carcinogenesis model is a well-known animal system that closely mimics the development of premalignant and malignant lesions in human oral cancer. Our aim was to numerically characterize the premalignant and malignant lesions and expressions of field cancerization in this model using ploidy as the end-point. METHODS: To study the DNA content and proliferation status of the cells in this model we assessed the Feulgen reaction and the immunohistochemical reaction for 5-bromo-2-deoxiuridine (BrdU) in different histological areas of serial tissue sections of the cheek pouches of animals injected with BrdU. RESULTS: Ploidy values were higher in cancerized epithelia with no unusual microscopic features (NUMF), in preneoplastic and tumor areas than in control epithelia. The aneuploidy index was higher in NUMF areas than in control and differed significantly from control in preneoplastic areas and carcinoma. CONCLUSIONS: The unexpected alteration in DNA content observed in NUMF epithelia is of great relevance as a biomarker of field cancerized areas.

9,10-Dimethyl-1,2-benzanthracene↗

The effect of three types of rasps on the occlusal surface of equine cheek teeth: a scanning electron microscopic study.

Two hand rasps (tungsten chip blade, solid carbide blade) and an electrically-driven solid carbide axial bur were used to treat the cheek teeth of 2 horses immediately postmortem. All teeth were normal and were rasped to a standard considered satisfactory in practice. Six teeth from each horse served as untreated controls. Following treatment, the teeth were extracted and the clinical crown removed and prepared for scanning electron microscopy. Teeth were also extracted and examined from a horse that had excessive dental treatment previously. Dental debris created by the procedures was collected and examined. All three rasp techniques resulted in amputation of odontoblast processes. The solid carbide blade cut deep gouges and grooves into the surface of the dentin, chipping the enamel and peripheral cement. No smear layer was created. Rasping with a tungsten chip blade created a partial smear layer and a smoother surface than the solid carbide blade. The electrically-driven bur produced a complete smear layer and removed all dental tissues to a smooth layer. The enamel had also been damaged by the electric bur. Crown particles collected after the procedures were larger following hand rasping compared with particles produced by the electric bur. The extent of damage to sensitive and vital dentin tissue was of concern. Further studies are required to establish the optimum technique for rasping equine cheek teeth.

Animals↗

Structure of peripheral cementum of normal equine cheek teeth.

The structure of peripheral cementum of mandibular and maxillary cheek teeth was studied by gross observation, light microscopy, and scanning and transmission electron microscopy. Teeth from four horses aged 4, 8, 17, and 30-years-old were examined. The cementum of the occlusal surface was thicker on the buccal aspect when compared with the lingual aspect of mandibular teeth. The cementum of the occlusal surface was thicker on the palatal aspect when compared with the buccal aspect of maxillary teeth. There was no peripheral cementum on the interdental aspects of either mandibular or maxillary cheek teeth. In the adult tooth, cementum covered the crown and root surfaces. The peripheral cementum of the gingival region showed a dramatic increase in thickness compared with cementum covering the alveolar portion of the embedded tooth. At a microscopic level, three layers (primary, secondary, and tertiary) were identified within cementum. The increase in cementum in the gingival region was of tertiary cementum. All three layers contained vital cementocytes. There was a well-developed vascular system within the cementum. Nerve bundles were also present. Three cementoblast profiles were identified at the junction of the cementum with the periodontal ligament. The results reported in this paper show that cementum is a dynamic vital tissue. These findings should contribute to a greater understanding of the etiology and pathogenesis of cemental caries and periodontal disease in the horse.

Aging↗

Immunohistochemical identification of lymphatic vessels in the periodontium of equine cheek teeth.

Immunohistochemical detection of lymphatic capillaries was performed in the periodontium of maxillary and mandibular cheek teeth from 6 horses (aged 3-23 years). Tissue sections of the periodontium were taken at 4 different horizontal levels along the long axis of the tooth. The specimens were processed for immunoreaction with anti-Prox1, in order to distinguish lymphatic endothelium from blood vascular endothelium. Lymphatic vessels were detected in all periodontal tissues except for the dental cementum. Lymphatic capillaries were most densely distributed in the gingiva compared to other tissues of the periodontium. Lymphatic capillaries were found most consistently in samples taken from the gingival and subgingival regions in all horses examined. Within these levels, the gingiva as well as the spongiosa of the maxillary and mandibular bone had the greatest incidence of lymphatic vessels. Considering the distinct distribution of the lymphatic capillaries in the periodontium of the maxillary and mandibular cheek teeth, two complementary lymphatic drainage pathways are proposed: (1) superficial lymph drainage via the gingiva, emptying into the mandibular lymph nodes; (2) deep lymph drainage via the mandibular and maxillary spongiosa, emptying into the mandibular and retropharyngeal lymph nodes, respectively.

Animals↗

Histological study on the postnatal development and sequence of eruption of the mandibular cheek-teeth of rabbits (Oryctolagus cuniculus).

The postnatal development and sequence of eruption of mandibular cheek teeth of rabbits were studied by histological methods. Hemi-mandibles were dissected and sectioned in longitudinal sections of 7 mu and stained with hematoxylin-eosin and Masson's trichrome. The presence of two mandibular deciduous molars which are replaced by corresponding premolars and of three mandibular permanent monofisary molars was confirmed. Eruption of deciduous molars of the mandible begins at 4 days after birth and of the mandibular permanent molars at 9 days, while that of mandibular premolars occurs at 23 days, replacing the mandibular deciduous molars which have exfoliated. At 32 days all the mandibular permanent cheek-teeth are erupted. At birth the mandibular deciduous molars are completely developed and at 4 days their root resorption is initiated. At the first day P3 is in the bell stage and the P4 has begun dentinogenesis. In M1 and M2 amelogenesis is observed.

Amelogenesis↗

Equine dental disease. Part 3: A long-term study of 400 cases: disorders of wear, traumatic damage and idiopathic fractures, tumours and miscellaneous disorders of the cheek teeth.

Of 400 horses referred because of dental disorders, 349 cases were diagnosed as suffering from primary disorders of their cheek teeth. Details of 104 of these cases are presented, including 44 cases with abnormalities of wear, 26 cases with traumatic damage, 24 cases with idiopathic fractures and 10 cases with miscellaneous cheek teeth disorders including oral tumours. The long-term response to treatment was excellent in most cases, even in cases with residual secondary periodontal disease.

Animals↗

Standing oral extraction of cheek teeth in 100 horses (1998--2003).

REASONS FOR PERFORMING STUDY: Extraction of cheek teeth (CT) by the conventional repulsion technique requires general anaesthesia and carries a high rate of post operative complications. Consequently, an alternative method of extraction, i.e. orally in standing horses, was evaluated. HYPOTHESIS: The need for and risks of general anaesthesia could be avoided and post extraction sequelae reduced by performing extractions orally in standing horses. METHODS: One hundred mainly younger horses (median age 8, range 2-18 years) with firmly attached CT that required extraction because of apical infections, displacements, diastemata, idiopathic fractures and the presence of supernumerary CT had the affected teeth (n = 111) extracted orally under standing sedation. Follow-up information was obtained for all cases, a median of 16 months later. RESULTS: Oral extraction was successful in 89 horses and unsuccessful in 11 due to damage to the CT clinical crown (n = 9) during extraction, for behavioural reasons (n = 1) and because the apex of a partly extracted CT fell back into the alveolus following sectioning (n = 1). Predispositions to extraction-related CT fractures were present in 5 of the 9 cases, i.e. advanced dental caries (n = 2) and pre-existing 'idiopathic' fractures (n = 3). The iatrogenically fractured CT were later repulsed under standing sedation (n = 3) and under general anaesthesia (n = 6). Eighty-one of the remaining 89 horses had successful oral CT extraction with no or minimal intra- or post operative complications occurring. Post operative complications in the other 8 cases included post extraction alveolar sequestration (n = 3), alveolar sequestration and localised osteomyelitis (n = 1), localised osteomyelitis (n = 1), incorporation of alveolar packing material into alveolar granulation tissue (n = 1), and nasal discharge due to continued intranasal presence of purulent food material (n = 1) and to ongoing sinusitis (n = 1). The above sequelae were treated successfully in all cases, with general anaesthesia required in just one case. Following oral extraction, significantly (P<0.001) fewer post operative problems developed in 54 horses with apically infected CT in comparison with 71 previous cases that had repulsion of apically infected CT at our clinic. CONCLUSIONS AND POTENTIAL RELEVANCE: Oral extraction of cheek teeth is a successful technique in the majority of younger horses with firmly attached CT and greatly reduces the post operative sequelae, compared with CT repulsion. Additionally, the costs and risks of general anaesthesia are avoided. Further experience and refinement in the described protocol could potentially increase the success of this procedure and also reduce the incidence of post operative sequelae.

Analgesics, Opioid↗

Atriopeptin does not augment the transvascular flux of macromolecules in the hamster cheek pouch.

Natriuretic peptides elaborated by atrial myocytes promote marked renal sodium and water excretion as a mechanism for fluid and electrolyte balance. Recent evidence suggests that atriopeptin (ANP) also targets the non-renal vasculature as a site for enhanced fluid exchange. It remains unclear whether ANP alters microvascular integrity to facilitate the efflux of both plasma and proteins across the endothelial barrier, or if fluid exchange is selectively enhanced. This study evaluated the influence of ANP on macromolecular transport through the direct observation of microvessels in the hamster cheek pouch using fluorescent intravital microscopy. Fluorescein isothiocyanate conjugated to either bovine serum albumin or dextran 150,000 Mw was utilized as a permeability probe. Macromolecular efflux was quantified as fluorochrome clearance. The clearance of fluorescein-conjugated bovine serum albumin (57.94 +/- 7.03) or fluorescein-conjugated dextran 150 (4.09 +/- 1.35) remained unaltered by intravascular injection of 1 microgram/kg ANP. Topical application of 40 ng to cheek pouch microvessels produced similar results. All pouches demonstrated positive leakage response to histamine 2.5 x 10(-6) M, increasing fluorochrome clearance approximately 2- to 11-fold. Bolus injection of 1 microgram/kg ANP reduced mean arterial pressure, increased urine flow from 6.63 +/- 2.59 microliters/min to 8.20 +/- 6.13 microliters/min, and elevated sodium excretion from 1.37 +/- 0.49 microEq/min to 2.54 +/- 0.99 microEq/min. These results suggest that ANP fails to significantly alter the integrity of the protein-transporting channels in the microvascular exchange barrier.

Animals↗

The value of vascularized tendon transfers with free flaps in perioral and cheek reconstructions.

The effect of gravity and the process of ageing necessitate the support of flaps used for the reconstruction of facial tissues. Perioral and cheek reconstructions exemplify this problem. Support can be obtained using vascularized tendons with free tissue transfers. The radial-forearm neurocutaneous flap with the vascularized palmaris longus tendon and the neurocutaneous lateral arm flap with the vascularized triceps tendon are useful options for resurfacing of these defects. We present 6 cases to highlight the use of the vascularized tendon transfer with free neurocutaneous tissue transfers as composite flaps in perioral and cheek reconstructions.

Adult↗

The relationship of maxillary cheek tooth development to age in young Friesian cattle.

Radiographs were taken of both the right and left sets of maxillary teeth in 23 Friesian cattle of known age. The stage of development of each permanent tooth was ascertained and the degree of root resorption in the deciduous premolars was noted. All stages in individuals were later than for those of the mandibular cheek teeth except in the case of the first permanent premolar. As with mandibular cheek tooth development stages of formation occurred within certain age limits.

Age Factors↗

[Observation on alpha-SMA during Erigeron Breviscapus (Vant) Hand-Mazz obstructs the evolution of carcinogenesis of golden hamster cheek pouch].

OBJECTIVE: To observe dynamically that Erigeron Breviscapus (Vant) Hand-Mazz (HEr) affects the expression of alpha-smooth muscle actin (alpha-SMA). To discuss the probable mechanism of obstructing leukoplakia carcinogenesis of this medicine. METHODS: 120 golden hamsters were randomly divided into model group (48), HEr group (48) and control group (6). HEr was applied to obstruct the evolution of carcinogenesis of golden hamster cheek pouch. Immunohistochemistry was used to detect the expression level of alpha-SMA with cheek pouch specimen that besmears DMBA in 4-9 weeks. Results were compared with model group. RESULTS: Vessel density dyed with alpha-SMA continuously of HEr group was 65.76 significantly higher than that of model group 42.12 (P<0.001). High classification cases in HEr group were much more than model group when cases were divided into five groups as follow: 100%, 50%, 20%, 10%, 3% (P<0.01). CONCLUSION: HEr can raise the expression level of alpha-SMA exactly during the evolution of leukoplakia carcinogenesis of golden hamster, which shows that this medicine obstructs carcinogenesis by keeping the normal physiological function of vascular myoepithelial cell and integrity of vascular basement membrane.

English Abstract↗