Histological, SEM and three-dimensional analysis of the midfacial SMAS - New morphological insights.

INTRODUCTION: The superficial musculoaponeurotic system (SMAS) of the midface has a complex morphological architecture, and a multitude of controversial opinions exist regarding its in vitro appearance and clinical relevance. The aim of this study was to investigate the three-dimensional architecture of the midfacial SMAS. METHOD: Histological and SEM analyses were performed on tissue blocks of the skin, subcutaneous tissue and mimic musculature of the midfacial region between the anterior parotid gland pole and lateral to the nasolabial fold and tissue blocks of the skin, subcutaneous tissue and parotid fascia. Blocks were collected postmortem from six formalin-fixed donor bodies. Serial histological sections were made, stained with Azan and digitized. Three-dimensional reconstructions and visualization of the tissue blocks were performed using AutoCAD. RESULTS: Two different SMAS architectures were found in the midfacial region: parotideal (type IV) and preparotideal (type I) SMAS. Type I SMAS showed three-dimensional interconnecting fibrous chambers embracing fat tissue lobules that cushioned the space between the skin and mimic musculature. Fibrous septa divided the mimic musculature surrounding the muscular bundles. Beneath the mimic muscular level, SMAS septa were oriented parallel to the muscular plane. Above the mimic muscular plane, SMAS septa were oriented perpendicularly, inserted into the skin. Type IV SMAS showed a parallel alignment of the fibrous septa to the skin level, anchoring the skin to the parotid fascia, presenting lymphatic nodes in the fat tissue compartments. The fat cells of the SMAS were enveloped in a fibrotic membrane at the border of the fibro-muscular septa. The SMAS blood supply comprised two subcutaneously epimuscularly spreading anastomosing vascular systems. CONCLUSIONS: Midfacial SMAS represents a functional unit with physical and immunological tasks appearing in two different morphological architecture types. A well-defined nomenclature is needed to prevent controversy.

Morphological analysis and three-dimensional reconstruction of the SMAS surrounding the nasolabial fold.

BACKGROUND: The superficial musculoaponeurotic system (SMAS), a structure that has been discussed with some controversy, has a complex morphological architecture. MATERIAL AND METHODS: Histological analysis was performed on tissue blocks of the nasolabial fold (NLF) collected postmortem from formalin-fixed bodies of one male and one female donor. Serial histological sections were made, stained and digitized. Three-dimensional reconstructions of the histological structures were performed. Specimen- and location-specific differences were determined. SEM analysis of the NLF tissue block was performed. RESULTS: The NLF SMAS is a fibro-muscular, three-dimensional meshwork bolstered with fat cells. Two SMAS structure types were identified adjacent to the NLF. The cheek SMAS structure showed a regular, vertical and parallel alignment of the fibrous septa, building a three-dimensional meshwork of intercommunicating compartments. It changed its morphology, condensing while transiting the NLF and passing over to form an irregular structure in the upper lip region. SEM analysis demonstrated the connection between the fibrous meshwork and the fat cells. SMAS blood circulation expanded subcutaneously without perforating the fibro-muscular septa. CONCLUSIONS: The NLF has a recognizable condensed cheek SMAS structure and represents the transition zone between the two SMAS types. Specimen-specific morphological differences necessitate individual planning and area-specific surgical procedures.

Determination of urinary trans,trans-muconic acid by gas chromatography-mass spectrometry.

A sensitive and specific method for the determination of trans,trans-muconic acid (t,t-MA) in urine is described. After clean-up on an anion-exchange cartridge, t,t-MA was derivatized with BF3-methanol to the dimethyl ester and analyzed by gas chromatography-mass spectrometry (GC-MS), with 2-bromohexanoic acid as an internal standard. The limit of detection was 0.01 mg/l, the coefficient of variation for duplicate analysis in a series of urine samples (n = 50) was 2.6% and the recovery rate ranged from 93.3 to 106.3%. The between-day and within-day precision for the analysis were 7.4 and 14.6%, respectively. The method was applied to the determination of t,t-MA in urine samples from smokers and non-smokers. The mean concentration of t,t-MA in urine of 10 smokers was 0.09 +/- 0.04 mg/g creatinine and was significantly (p = 0.012) higher than that found in urine of 10 non-smokers (0.05 +/- 0.02 mg/g creatinine). In contrast to the results obtained with the commonly used high-performance liquid chromatographic ultraviolet detection (HPLC-UV) methods, no interference between t,t-MA and other urinary compounds was found. This GC-MS method is both specific and sensitive for biomonitoring of low environmental benzene exposure.

Concentrations of benzene in blood and S-phenylmercapturic and t,t-muconic acid in urine in car mechanics.

Different parameters of biological monitoring were applied to 26 benzene-exposed car mechanics. Twenty car mechanics worked in a work environment with probably high benzene exposures (exposed workers); six car mechanics primarily involved in work organization were classified as non-exposed. The maximum air benzene concentration at the work places of exposed mechanics was 13 mg/m3 (mean 2.6 mg/m3). Elevated benzene exposure was associated with job tasks involving work on fuel injections, petrol tanks, cylinder blocks, gasoline pipes, fuel filters, fuel pumps and valves. The mean blood benzene level in the exposed workers was 3.3 micrograms/l (range 0.7-13.6 micrograms/l). Phenol proved to be an inadequate monitoring parameter within the exposure ranges investigated. The muconic and S-phenylmercapturic acid concentrations in urine showed a marked increase during the work shift. Both also showed significant correlations with benzene concentrations in air or in blood. The best correlations between the benzene air level and the mercapturic and muconic acid concentrations in urine were found at the end of the work shift (phenylmercapturic acid concentration: r = 0.81, P < 0.0001; muconic acid concentration: r = 0.54, P < 0.05). In conclusion, the concentrations of benzene in blood and mercapturic and muconic acid in urine proved to be good parameters for monitoring benzene exposure at the workplace even at benzene air levels below the current exposure limits. Today working as a car mechanic seems to be one of the occupations typically associated with benzene exposure.