Macrophages play an important role in aging-related muscle atrophy (i.e., sarcopenia). We examined macrophage density in six striated muscles (cricopharyngeus muscle, posterior cricoarytenoideus muscle, genioglossus muscle, masseter muscle, infraspinatus muscle, and external anal sphincter). We examined 14 donated male cadavers and utilized CD68 immunohistochemistry to clarify macrophage density in muscles. The numbers of macrophages per striated muscle fiber in the larynx and pharynx (0.34 and 0.31) were 5–6 times greater than those in the tongue, shoulder, and anus (0.05–0.07) with high statistical significance. Thick muscle fibers over 80 µm in diameter were seen in the pharynx, larynx, and anal sphincter of two limited specimens. Conversely, in the other sites or specimens, muscle fibers were thinner than 50 µm. We did not find any multinuclear muscle cells suggestive of regeneration. At the beginning of the study, we suspected that mucosal macrophages might have invaded into the muscle layer of the larynx and pharynx, but we found no evidence of inflammation in the mucosa. Likewise, the internal anal sphincter (a smooth muscle layer near the mucosa) usually contained fewer macrophages than the external sphincter. The present result suggest that, in elderly men, thinning and death of striated muscle fibers occur more frequently in the larynx and pharynx than in other parts of the body.
Aged* ; Anal Canal ; Cadaver* ; Deglutition ; Deglutition Disorders ; Humans ; Humans* ; Immunohistochemistry ; Inflammation ; Laryngeal Muscles* ; Larynx ; Macrophages* ; Male ; Masseter Muscle ; Mucous Membrane ; Muscle Cells ; Muscle, Smooth ; Muscle, Striated* ; Muscles ; Muscular Atrophy ; Pharynx ; Regeneration ; Sarcopenia ; Shoulder ; Tongue

In an attempt to clarify the function of the suboccipital muscles, we performed morphological observation of the suboccipital muscles for variations in the muscle belly and compared the morphology of their muscle fibers in terms of cross-sectional area by immunostaining with anti-myosin heavy chain antibodies. The cadavers of 25 Japanese individuals were used: 22 for morphological examinations and three for histological examinations. Among samples of the rectus capitis posterior major muscle (RCPma) and rectus capitis posterior minor muscle (RCPmi), 86.4% had a typical muscle appearance with a single belly, and 13.6% had an anomalous morphology. None of the samples of the obliquus capitis superior (OCS) or obliquus capitis inferior (OCI) muscles had an anomalous appearance. Measurement of cross-sectional area revealed that fast-twitch muscle fibers in the RCPma and OCI had a significantly greater cross-sectional area than those of the RCPmi and OCS. The cross-sectional area of intermediate muscle fibers was also significantly greater in the OCS than in the RCPma, RCPmi, and OCI. The cross-sectional area of slow-twitch muscle fibers was significantly greater in the OCS than in the RCPma, RCPmi, and OCI, and the RCPmi showed a significantly greater cross-sectional area for slow-twitch muscle fibers than did the RCPma, and OCI. Our findings indicate that the RCPmi and OCS exert a greater force than the RCPma and OCI, and act as anti-gravity agonist muscles of the head. Prolonged head extension in individuals with anomalous suboccipital muscle groups could result in dysfunction due to undue stress.
Antibodies ; Asian Continental Ancestry Group ; Cadaver ; Classification* ; Head ; Headache ; Humans ; Muscle Fibers, Fast-Twitch ; Muscle Fibers, Slow-Twitch ; Muscles

We compared the age-related morphology of the cricothyroid (CT) joint with that of the cricoarytenoid (CA) joint using 18 specimens from elderly cadavers in terms of their elastic fiber contents as well as the cells composing the joint capsule and synovial tissues. In contrast to an almost flat-flat interface in the CT joint, the CA joint was similar to a saddle joint. The CA joint capsule was thin and contained few elastic fibers, and in contrast to the CT joint, external fibrous tissues were not exposed to the joint cavity, there being no injury to the CA joint capsule. The lateral and posterior aspects of the CA joint were covered by the lateral and posterior CA muscles, respectively, and the fascia of the latter muscle was sometimes thick with abundant elastic fibers. However, due to possible muscle degeneration, loose connective tissue was often interposed between the fascia and the capsule. The medial and anterior aspects of the CA joint faced loose tissue that was continuous with the laryngeal submucosal tissue. Therefore, in contrast to the CT joint, a definite supporting ligament was usually absent in the CA joint. Synovial folds were always seen in the CA joint, comprising a short triangular mass on the posterior side and long laminar folds on the anterior side. The synovial folds usually contained multiple capillaries and a few CD68-positive macrophages. High congruity of the CA joint surfaces as well as strong muscle support to the arytenoid cartilage appeared to provide the specific synovial morphology.
Aged* ; Arytenoid Cartilage ; Cadaver ; Capillaries ; Connective Tissue ; Elastic Tissue ; Fascia ; Humans ; Joint Capsule ; Joints* ; Ligaments ; Macrophages ; Muscles

BACKGROUND: Pedicled flaps are useful for reconstructive surgery. Previously, we often used vascularized supraclavicular flaps, especially for head and neck reconstruction, but then shifted to using thoracic branch of the supraclavicular artery (TBSA) flaps. However, limited research exists on the anatomy of TBSA flaps and on the use of indocyanine green (ICG) fluorescence videoangiography for supraclavicular artery flaps. We utilized ICG fluorescence videoangiography to harvest reliable flaps in reconstructive operations, and describe the results herein. METHODS: Data were retrospectively reviewed from six patients (five men and one woman: average age, 54 years; range, 48–60 years) for whom ICG videoangiography was performed to observe the skin perfusion of a supraclavicular flap after it was raised. Areas where the flap showed good enhancement were considered to be favorable for flap survival. The observation of ICG dye indicated good skin perfusion, which is predictive of flap survival; therefore, we trimmed any areas without dye filling and used the remaining viable part of the flap. RESULTS: The flaps ranged in size from 13×5.5 cm to 17×6.5 cm. One patient received a conventional supraclavicular flap, four patients received a TBSA flap, and one patient received a flap that was considered to be intermediate between a supraclavicular flap and a TBSA flap. The flaps completely survived in all cases, and no flap necrosis was observed. CONCLUSIONS: The TBSA flap is very useful in reconstructive surgery, and reliable flaps could be obtained by using ICG fluorescence videoangiography intraoperatively.
Arteries ; Female ; Fluorescence ; Head ; Humans ; Indocyanine Green ; Male ; Neck ; Necrosis ; Perfusion ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Flaps

Human fetal cervical vertebrae are characterized by the large zygapophysial joint (ZJ) extending posteriorly. During our recent studies on regional differences in the shape, extent, and surrounding tissue of the fetal ZJ, we incidentally found a cervical-specific structure of synovial tissues. This study aimed to provide a detailed evaluation of the synovial structure using sagittal and horizontal sections of 20 near-term fetuses. The cervical ZJ consistently had a large cavity with multiple recesses at the margins and, especially at the anterior end, the recess interdigitated with or were located close to tree-like tributaries of the veins of the external vertebral plexus. In contrast to the flat and thin synovial cell lining of the recess, the venous tributary had cuboidal endothelial cells. No or few elastic fibers were identified around the ZJ. The venous-synovial complex seems to be a transient morphology at and around birth, and it may play a role in the stabilization of the growing cervical ZJ against frequent spontaneous dislocation reported radiologically in infants. The venous-synovial complex in the cervical region should be lost and replaced by elastic fibers in childhood or adolescence. However, the delayed development of the ligament flavum is also likely to occur in the lumbar ZJ in spite of no evidence of a transient venous-synovial structure. The cuboidal venous endothelium may simply represent the high proliferation rate for the growing complex.

Human fetal cervical vertebrae are characterized by the large zygapophysial joint (ZJ) extending posteriorly. During our recent studies on regional differences in the shape, extent, and surrounding tissue of the fetal ZJ, we incidentally found a cervical-specific structure of synovial tissues. This study aimed to provide a detailed evaluation of the synovial structure using sagittal and horizontal sections of 20 near-term fetuses. The cervical ZJ consistently had a large cavity with multiple recesses at the margins and, especially at the anterior end, the recess interdigitated with or were located close to tree-like tributaries of the veins of the external vertebral plexus. In contrast to the flat and thin synovial cell lining of the recess, the venous tributary had cuboidal endothelial cells. No or few elastic fibers were identified around the ZJ. The venous-synovial complex seems to be a transient morphology at and around birth, and it may play a role in the stabilization of the growing cervical ZJ against frequent spontaneous dislocation reported radiologically in infants. The venous-synovial complex in the cervical region should be lost and replaced by elastic fibers in childhood or adolescence. However, the delayed development of the ligament flavum is also likely to occur in the lumbar ZJ in spite of no evidence of a transient venous-synovial structure. The cuboidal venous endothelium may simply represent the high proliferation rate for the growing complex.

We have previously reported that the thoracolumbar posterior nerve root shows a tortuous epidural course, based on studies of human fetuses near term. For comparison with the cervical nerve, examinations were conducted using frontal, sagittal and horizontal sections of cervical vertebrae from 22 fetuses at 30–38 weeks of gestation. The cervical nerve root showed a short, straight and lateral course near the zygapophysial joint. Multiple rather than single bundles of the cervical posterior root seemed to account for the majority of sensory nerve fibers innervating the upper extremity. Fasciculation of rootlets was evident near the thoracolumbar spinal cord, whereas it was seen in the dural pocket at the nerve exit from the dural sac although both sites were subdural. As in the thoracolumbar region, the nerve sheath was continuous with the dura mater and independently surrounded each of the anterior and posterior roots. Radicular arteries were few in the cervical region. In 2 of the 22 fetuses (31 weeks and 33 weeks), there was a segmental, unilateral abnormality of nerve rootlet fasciculation where the dorsal root ganglion was located lateral or peripheral to the intervertebral region. Long nerve roots running inferiorly are a necessary adaptation to the delayed and marked growth of the thoracolumbar vertebral column.In children, the cervical nerve roots are likely to be affected by movement or dislocation of the vertebrae. The segmental abnormality of the cervical nerve root may be linked to rare variations in the brachial plexus.

The temporal fascia is a double lamina sandwiching a thick fat layer above the zygomatic bony arch. To characterize each lamina, their developmental processes were examined in fetuses. We observed histological sections from 22 half-heads of 10 mid-term fetuses at 14–18 weeks (crown-rump length, 95–150 mm) and 12 near-term fetuses at 26–40 weeks (crown-rump length, 215–334 mm). The superficial lamina of the temporal fascia was not evident at mid-term. Instead, a loose subcutaneous tissue was attached to the thin, deep lamina of the temporal fascia covering the temporalis muscle. At near-term, the deep lamina became thick, while the superficial lamina appeared and exhibited several variations: i) a monolayered thick membrane (5 specimens); ii) a multi-layered membranous structure (6) and; iii) a cluster of independent thick fasciae each of which were separated by fatty tissues (1). In the second and third patterns, fatty tissue between the two laminae was likely to contain longitudinal fibrous bands in parallel with the deep lamina. Varying proportions of the multi-layered superficial lamina were not attached to the zygomatic arch, but extended below the bony arch. Whether or not lobulation or septation of fatty tissues was evident was not dependent on age. The deep lamina seemed to develop from the temporalis muscle depending on the muscle contraction. In contrast, the superficial lamina developed from subcutaneous collagenous bundles continuous to the cheek. Therein, a difference in development was clearly seen between two categories of the fasciae.