Macrophage density in pharyngeal and laryngeal muscles greatly exceeds that in other striated muscles: an immunohistochemical study using elderly human cadavers.

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.

Regional Anatomical Observation of Morphology of Greater Palatine Canal and Surrounding Structures.

In maxillary molar region implant therapy, support is sometimes obtained from trabecular bone comprising the maxillary tuberosity, pterygoid process of the sphenoid bone, and pyramidal process of the palatine bone. Great care is necessary in such cases due to the presence of the greater palatine canal, which forms a passageway for the greater palatine artery, vein, and nerve. However, clinical anatomical reports envisioning embedding of pterygomaxillary implants in this trabecular bone region have been limited in number. In this study, the 3-D morphology of the greater palatine canal region, including the maxillary tuberosity region and points requiring particular care in pterygomaxillary implantation, were therefore investigated. Micro-CT was used to image 20 dentulous jaws (40 sides) harvested from the dry skulls of Japanese individuals with a mean age of 28.2 years at time of death. The skulls were obtained from the Jikei University School of Medicine cadaver repository. Three-dimensional reconstruction of the trabecular bone region, including the greater palatine canal, was performed using software for 3-D measurement of trabecular bone structure. Trabecular bone region morphometry was performed with the hamular notch-incisive papilla (HIP) plane as the reference plane. The results showed a truncated-cone structure with the greater palatine foramen as the base extending to the pterygopalatine fossa. This indicates the need for care with respect to proximity of the dental implant body to the greater palatine canal and the risk of perforation if it is embedded in the maxillary tuberosity region at an inclination of 60° toward the lingual side. Moreover, caution must be exercised to avoid possible damage to the medial wall of the maxillary sinus if the inclination of the embedded dental implant body is almost perpendicular to the HIP plane.

Expression of intermediate filaments at muscle insertions in human fetuses.

Desmin and vimentin are intermediate filaments that play crucial roles in the maturation, maintenance and recovery of muscle fibers and mesenchymal cells. The expression of these proteins has not been investigated extensively in human fetuses. In the present study, we examined the immunohistochemical expression of intermediate filaments in skeletal muscles of the head, neck and thorax in 12 mid-term human fetuses at 9-18 weeks of gestation. We also used immunohistochemistry to localize the expression of the myosin heavy chain and silver impregnation to identify the fetal endomysium. Expression of desmin and vimentin was already detectable in intercostal muscle at 9 weeks, especially at sites of muscle attachment to the perichondrium. At this stage, myosin heavy chain was expressed throughout the muscle fibers and the endomysium had already developed. Beginning with punctate expression, the positive areas became diffusely distributed in the muscle fibers. At 15-18 weeks, intermediate filament proteins were extensively expressed in all of the muscles examined. Expression at the bone-muscle interface was continuous with expression along the intramuscular tendon fibres. These results suggest that the development of intermediate filaments begins in areas of mechanical stress due to early muscle contraction. Their initially punctate distribution, as observed here, probably corresponds to the earliest stage of fetal enthesis formation.