Effects of female bone marrow transplantation on male reproductive organs

Graft-versus-host disease (GVHD), an adverse effect after bone marrow transplantation (BMT), may affect male reproductive function. It is hypothesized that a sex-mismatched BMT induces GVHD in male reproductive organs because female immune cells are not immunologically tolerant to specific antigens of the male organs. However, this hypothesis has not been experimentally verified using male (M) recipient animals following BMT from the female (F) donors. Therefore, the aim of the present study is to examine whether the female BMT to males (F→M group) induces some GVHD reactions in the testis and the other male reproductive organs. The results showed that no inflammation was found in recipients of the male BMT to males (M→M group), whereas significant inflammatory cell responses lasting for at least 4 months were induced in testis, epididymis, prostate and preputial gland in some mice of F→M group. The most severe lesion was found in the preputial gland, in which lymphocytic inflammation was accompanied by loss of glandular acini, thickening of the interstitum and increased cytokines such as TNF-α and IFN-γ. Western blot analyses revealed that sera from the F→M group reacted with various antigens of the male reproductive organs. These results indicate that transplanted female immune cells may recognize the male reproductive organs as immunologically foreign ones and induce chronic GVHD, which may affect male reproductive function.

Two Types of Variational Arteries' Courses From the Superior Mesenteric Artery to Supply the Splenic Flexure: Gross Anatomical Study

BACKGROUND

Complete mesocolic excision with central vascular ligation is a standard method for managing colon cancer. However, there is no consensus on its procedure, especially for cancer in the splenic flexure of the transverse colon. This is because various types of variational arteries are distributed to the region, and their running course below and near the pancreas leads to difficulty in ligating the artery.

OBJECTIVE

To clarify the arterial distribution to the splenic flexure of the transverse colon using cadavers.

DESIGN

The arteries in the transverse mesocolon distributed to the colon were dissected in cadavers, and their route was quantitatively visualized using drawing software.

SETTINGS

This study was conducted at the Department of Anatomy, Tokyo Medical University.

PATIENTS

Sixty cadavers donated to Tokyo Medical University in 2017-2021 were used.

MAIN OUTCOME MEASURES

The arterial courses to the splenic flexure of the transverse colon in the mesocolon and their patterns were evaluated.

RESULTS

We found 34 variational arteries distributed to the splenic flexure of the transverse colon. Most originated from the superior mesenteric artery and the middle colic artery, with their typical course below the pancreas. We identified another arterial course, crossing the mesocolon away from the pancreas toward the splenic flexure of the transverse colon. Furthermore, the origin of these arteries was not behind the pancreas and can be found in the caudal region of the pancreas.

LIMITATIONS

We cannot discuss how the arteries within the transverse mesocolon are observed by CT examination.

CONCLUSIONS

This study showed 2 types of arterial courses (below the pancreas and within the mesocolon) toward the splenic flexure of the transverse colon for the first time. In the latter case, the complete mesocolic excision with central vascular ligation is likely performed more easily than in the former. See Video Abstract.

DOS TIPOS DE RECORRIDO VARIACIONAL DE LA ARTERIA DESDE LA ARTERIA MESENTRICA SUPERIOR PARA IRRIGAR EL NGULO ESPLNICO ESTUDIO ANATMICO MACROSCPICO

ANTECEDENTES:La escisión mesocólica completa con ligadura vascular central es un método estándar para el cáncer de colon. Sin embargo, no hay consenso sobre su procedimiento, especialmente para el cáncer en el ángulo esplénico del colon transverso. Esto se debe a que varios tipos de arterias variacionales se distribuyen en la región, y su recorrido por debajo y cerca del páncreas dificulta la ligadura de la arteria.OBJETIVO:Este estudio tuvo como objetivo aclarar la distribución arterial al SF del colon transverso utilizando cadáveres.DISEÑO:Las arterias en el mesocolon transverso distribuidas al colon fueron disecadas en cadáveres, y su ruta fue visualizada cuantitativamente utilizando un software de dibujo.AJUSTES:Este estudio se realizó en el Departamento de Anatomía de la Universidad Médica de Tokio.PACIENTES:Se utilizaron sesenta cadáveres donados a la Universidad Médica de Tokio en 2017-2021.PRINCIPALES MEDIDAS DE RESULTADO:Se evaluaron los cursos arteriales al ángulo esplénico del colon transverso en el mesocolon y sus patrones.RESULTADOS:Encontramos 34 arterias variacionales distribuidas al ángulo esplénico del colon transverso. La mayoría se originaron en la arteria mesentérica superior y la arteria cólica media, con su trayecto típico por debajo del páncreas. Identificamos otro curso arterial, cruzando el mesocolon alejándose del páncreas hacia el ángulo esplénico del colon transverso. Además, el origen de estas arterias no estaba detrás del páncreas y se pueden encontrar en la región caudal del páncreas.LIMITACIONES:No podemos discutir cómo se observan las arterias dentro del mesocolon transverso mediante un examen de tomografía computarizada.CONCLUSIONES:Este estudio mostró por primera vez dos tipos de trayectos arteriales (por debajo del páncreas y dentro del mesocolon) hacia el ángulo esplénico del colon transverso. En el último caso, es probable que la escisión mesocólica completa con ligadura vascular central se realice más fácilmente que en el primero. (Traducción-Dr. Aurian Garcia Gonzalez ).

Neurotransmission, Vasculogenesis, and Osteogenesis Activities are Altered in the Aging Temporomandibular Joint of the Senescence-Accelerated Prone 8 Mouse Model

BACKGROUND

Alterations in neurotransmission, vasculogenesis, and osteogenesis pathways that may play pivotal roles in age-related changes in the temporomandibular joint (TMJ) are poorly understood.

PURPOSE

This study aimed to measure the associations between gene and protein profiles in senescence-accelerated prone 8 (SAMP8) mice.

STUDY DESIGN

The investigators designed and used 3 groups of 2 mouse models: 1) early aging SAMP8 at 24 weeks of age and control SAMR1 at 12 and 24 weeks (each stage n = 12).

PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE

The independent variable was investigated using 3 mouse models: an early aging mouse model and a control mouse model (12 and 24 weeks).

MAIN OUTCOME VARIABLE(S)

The primary outcome variables were CGRP, VEGF-A, CD31, LYVE-1, osteocalcin, osteopontin, type I and II collagen, and MMP-2. The secondary outcome variables were histological characteristics.

COVARIATES

Not applicable.

ANALYSES

The gene and protein expression profiles of neurotransmitters, vasculogenesis, and osteogenesis were identified by quantitative real-time polymerase chain reaction and dot blot analysis, respectively. The cellular localization of these events was verified by in situ hybridization and immunohistochemistry. Bivariate statistics were computed for each of the outcome variables. Statistical significance was set to a P value < .05.

RESULTS

The expression of CGRP mRNA in the bony mandibular condyle (BMC) of SAMP8 mice (SAMP8, 3.3 ± 0.39 vs SAMR1, 0.001 ± 0.0001) was high at 24 weeks of age (24 weeks) (P < .001). Higher numbers of cells positive percentage for CGRP (MF, SAMP8, 28.67 ± 1.60 vs SAMR 1, 6.36 ± 1.10; CMC, 27.5 ± 2.12 vs 9.00 ± 1.21; BMC, 31.31 ± 2.81 vs 7.85 ± 1.14) and VEGF-A (MF, 34.43 ± 2.45 vs 14.01 ± 1.28; MD, 32.69 ± 1.86 vs 8.00 ± 0.91; CMC, 36.60 ± 2.05 vs 14.19 ± 1.25 BMC 36.49 vs 12.59 ± 1.41) antibodies were found in the 24 weeks TMJ (P < .01).

CONCLUSIONS AND RELEVANCE

The neurotransmitter, vasculogenesis, and osteogenesis pathways are associated with TMJ aging in the SAMP8 mouse model. In the future, the SAMP8 mouse model may prove to be a robust model for identifying molecular and biochemical events underlying the effects of feeding, occlusal changes, and tooth loss in the aging TMJ.

Distribution of Contractile Structures in a Mouse and Human Lymph Node Associated with Lymph Flow

Lymph nodes have contractile structures, but their distribution in a lymph node has been less considered in terms of facilitation of lymph flow. Axillary, inguinal, and mesenteric lymph nodes were collected from mice and human cadavers, and their sections were immunostained for alpha-smooth muscle actin (αSMA) and high molecular weight caldesmon (H-caldesmon). The αSMA-positive cells were localized in the capsule beneath the ceiling epithelium on the afferent side in both mice and humans. We found an additional layer of the αSMA-positive cells in the human lymph node, surrounding the inner layer perpendicularly. H-caldesmon was expressed only in these cells of the outer layer. In some human lymph nodes highly containing fat tissue in the medulla, the capsule disappeared on the efferent side, resulting in a disrupted sinusoidal lymph pathway. These findings suggest that human lymph nodes have additional smooth muscles in the outer region of the capsule to facilitate lymph flow. The αSMA-positive cells in the outer and inner layers of human lymph nodes probably have different functions in contraction. The presence of lipomatosis in a human lymph node will reduce its contribution to the lymph flow.

Relationship between scapular elevation exercises with different alignments and activity of the trapezius and levator scapulae muscles

[Purpose] This study aimed to examine whether scapular elevation exercises in sitting positions with different alignments lead to contractions of the trapezius and levator scapulae muscles. [Participants and Methods] The participants were 25 males, measured in four sitting positions with different alignments. Spine alignment was assessed by measuring the head protrusion, upper thoracic spine tilt, and pelvic tilt angles. Upper limb alignment was evaluated using the scapula tilt angle, scapula rotation angle, and distance between scapular spinous processes. Scapular elevation exercises were measured, and the thickness of the trapezius and levator scapulae muscles were measured in resting and elevated positions, with changes in muscle thickness. [Results] The trapezius muscle thickness was greater in the sitting position with less thoracic spine tilt and scapula tilt angles. Conversely, the levator scapulae muscle thickness was greater in the sitting position with more thoracic spine tilt and scapula tilt angles. [Conclusion] Scapular elevation exercises induce separate contractions of the trapezius and levator scapulae muscles by modifying the alignment of the spine and upper limbs.

Structural and CBCT analysis of mandibular canal microvessels expressing neurotransmitters in human cadavers

PURPOSE

This study focused on the detailed structure of microvessels of the neurotransmitter-positive vasa nervorum of the inferior alveolar nerve, vein, and artery in the mandibular canal (MC) to obtain information for improved safety in dental treatments. We also observed the detailed structure of the MC from the mental foramen to the mandibular foramen using cone-beam computed tomography (CBCT).

METHODS

In this study, mandibles from 45 sides of 23 human cadavers aged 76-104 years were examined by microscopy, immunohistochemistry, and CBCT analysis. These data were further evaluated by principal component analysis (PCA).

RESULTS

The microvessels of the vasa nervorum with calcitonin gene-related peptide- and neuropeptide Y-positive reactions were classified into 5 types: large (4.19%, 28/667); irregular large (7.35%, 49/667), numerous intermediate (29.23%, 195/667), irregular intermediate (29.23%, 195/667), and scattered fine (30.0%, 200/667) microvessels. The MC showed various structures from the 3rd molar to the premolars and was also classified into three types, including complete (57.0%, 228/400), partial (33.8%, 135/400), and unclear (9.2%, 37/400), from the mandibular foramen to the mental foramen. PCA results revealed that developed capillaries were mainly localized in the molar region.

CONCLUSIONS

Fine microvessels of the vasa nervorum expressing neurotransmitters are present from the molar to premolar region, which is key information for mandibular dental treatments. The different microvessel structures also indicate differences in specific characteristics between dentulous and edentulous cadavers regarding oral surgical and implant treatments.

Expression of neurotransmitters, vasculogenesis markers and myosin heavy chain isoforms in the masseter muscle of senescence-accelerated mouse prone 8 mice

BACKGROUND

Learning and memory deficits and pathologic changes in the hippocampus caused by toothlessness and soft diet feeding are related to reduced masseter muscle (MM) function.

OBJECTIVE

Myosin heavy chain (MyHC) isoform expression in the MM also changes under different chewing conditions. The neurotransmitter calcitonin gene-related peptide (CGRP) and vascular endothelial growth factor A (VEGF-A) are involved in MM formation. However, the relationship between CGRP, VEGF-A and MyHC isoforms in the MM in the senescence-accelerated mouse prone 8 (SAMP8) strain, a model of learning and memory deficits, remains unclear.

METHODS

Changes in CGRP, VEGF-A, vasculogenesis marker, and MyHC isoform mRNA expression in the MMs of aging SAMP8 and senescence-accelerated mouse resistant 1 (SAMR1) mice was investigated through quantitative real-time polymerase chain reaction (qRT-PCR) and in situ hybridization.

RESULTS

qRT-PCR revealed obviously high CGRP levels in the SAMP8 mouse MM (p<0.001). MyHC-IId/x mRNA expression in the MM was higher in 24-week-old SAMP8 mice than 24-week-old SAMR1 mice (p<0.001) but lower in slow-MyHC SAMP8 mice than SAMR1 mice (p<0.001). CGRP mRNA was observed on the muscle fibers of the SAMP8 mouse MM but not the SAMR1 mouse MM through in situ hybridization. Principal component analysis (PCA) revealed strong positive contributions of SAMP8-MyHC-IId/x, SAMP8-CGRP, SAMR1-MyHC-emb, SAMR1-CGRP, SAMR1-VEGF-A, SAMR1-CD31, SAMP8-VEGF-A, and SAMP8-CD31 in the MM at 12 and 24 weeks.

CONCLUSION

CGRP is also key for the MyHC-IId/x and slow-MyHC patterns in the MMs of SAMP8 mice.

The interrelationship between three-dimensional foot mobility and bodyweight bearing

[Purpose] To clarify the three-dimensional nature of foot mobility and its interrelationships within the foot due to bodyweight bearing. [Participants and Methods] Data regarding left foot mobility due to body weight bearing were collected from 31 healthy adults. Foot shape differences while sitting and standing, and their interrelationship were examined. The same examiner reapplied the landmark stickers when misaligned during measurement position changes. [Results] The foot length, heel width, forefoot width, hallux valgus angle, and calcaneus eversion angle were significantly larger in the standing than in sitting position. The digitus minimus varus angle was significantly smaller in the standing than in sitting position. The medial and lateral malleoli, navicular, and dorsum of the foot were displaced medially and inferiorly; the other indices, except for the midfoot, were displaced anteriorly. The interrelationships within the foot showed a positive correlation between the calcaneus eversion angle and the medial displacement of the medial and lateral malleoli, navicular, and dorsum of the foot points. There was a negative correlation between the calcaneus eversion angle and inferior displacement of the medial malleolus, navicular, and dorsum of the foot. [Conclusion] The intra-foot coordination relationship in response to bodyweight bearing was clarified.

Relationship between the bilateral ratios of the thoracic shape and electromyographic activity of the thoracic and lumbar iliocostalis muscles during thoracic lateral translation

[Purpose] This study aimed to determine the relationship between thoracic lateral deviation, the bilateral ratio of the thoracic shape, and the bilateral ratio of the thoracic and lumbar iliocostalis muscles during resting sitting and thoracic lateral translation. [Participants and Methods] We included 23 healthy adult males in the study. The measurement tasks were resting sitting and thoracic lateral translation relative to the pelvis. The thoracic lateral deviation and bilateral ratio of the upper and lower thoracic shapes were measured using three-dimensional motion capture. The bilateral ratio of the thoracic and lumbar iliocostalis muscles were measured using the surface electromyographic recording. [Results] The bilateral ratio of the lower thoracic shape was significantly positively correlated with the thoracic translation distance and the bilateral ratio of the thoracic and iliocostalis muscles. In addition, the bilateral ratio of the thoracic iliocostalis muscles was significantly negatively correlated with the bilateral ratios of the lower thoracic shape and lumbar iliocostalis muscles. [Conclusion] Our findings showed that the asymmetry of the lower thoracic shape is associated with left lateral deviation of the thorax at rest and thoracic translation distance. In addition, the thoracic and lumbar iliocostalis muscle activity differed between the left and right translations.

Three-dimensional structure of the facial canal and related blood vessels and nerves in the temporal bone

PURPOSE

There are only limited anatomical data on nerves, veins, and arteries in the temporal bone. More detailed anatomical data are required to improve planning of treatments targeting the temporal bone region. Herein, we performed a detailed analysis of the facial canal (FC) and the related carotid artery and vein.

METHODS

We examined the bony structure of the middle ear and FC, jugular foramen, and carotid canal in 30 Japanese elderly donor cadavers. Three-dimensional reconstruction of the canal structure was achieved using cone beam computed tomography, while macroscopic and histological analyses were also performed.

RESULTS

The FC form was classified as either straight (28%) or bent (72%). There were significant differences in the diameter of the FC and the distance between the internal jugular vein, other FC branches, and the FC. Principal component analysis (PCA) was performed for the FC using 29 factors. Two principal components significantly explained 30.9% (component 1, 18.6%; component 2, 12.3%) of the FC. Histological observation showed numerous ganglion cells and shrunken neurons in the geniculate ganglion of the facial nerve of elderly samples.

CONCLUSION

FC diameter is an important contributor to the relationship between the FC and the jugular foramen. The FC and the internal jugular vein are located close to each other, which is useful information for the trans-canal surgery of the otology. Furthermore, the geniculate ganglion contains numerous ganglion cells and shrunken neurons, which may affect the FC structure during bone matrix remodeling with aging.

Relationship between the thoracic asymmetry in standing position and the asymmetry of ankle moment in the frontal plane during gait

[Purpose] We aimed to investigate the relationship of thoracic asymmetry in standing position with asymmetry of the internal ankle moment in the frontal plane during gait. [Participants and Methods] The following measurements were recorded in 22 healthy adult males using a 3D motion analyzer and force plates: thoracic lateral deviation, asymmetrical ratios of the upper and lower thoracic shape, internal ankle moment in the frontal plane, mediolateral deviations of the center of mass and center of pressure. [Results] In the standing position, the thorax was deviated to the left relative to the pelvis, and the upper and lower thoracic shapes were asymmetrical. During gait, significant lateralities were observed in the internal ankle moment in the frontal plane, mediolateral deviations of the center of mass and the center of pressure. Significant positive correlations were observed between the asymmetrical ratio of the lower thoracic shape and both the asymmetry of the internal ankle moment in the frontal plane and the mediolateral deviation of the center of pressure. [Conclusion] These results suggest that thoracic asymmetry is associated with mediolateral control of the ankle during gait.

Characteristic expression of CGRP and osteogenic and vasculogenic markers in the proximal and distal regions of the rib during male mouse development

BACKGROUND

Neuropeptide calcitonin gene-related peptide (CGRP) is a neurotransmitter related to vasculogenesis and osteogenesis during bone formation and organ development. From the foetal period to the postnatal period, the thorax, which is necessary for lung respiration, forms. The thorax exhibits the same cartilage ossification as the bones of the extremities, but a specific system within the thorax exists as costal cartilage after birth. The relationship among CGRP, osteogenesis and vasculogenic markers in the two rib locations during thorax formation is not fully understood.

MATERIALS AND METHODS

In our study, male mice were used to provide ribs under different development conditions on various embryonic days (E12. 5, E14.5, and E17.5) and postnatal days (P1 and P5). The mRNA expression levels of CGRP, vascular endothelial growth factor (VEGF-A), type 1 collagen (Col1a-1), type 2 collagen (Col2a1), neuropeptide Y (NPY), osteocalcin (OCN) and osteopontin (OPN) were analysed by qRT-PCR. We also analysed the mRNA expression of CGRP, VEGF-A and OPN by in situ hybridization. Multivariate modelling with principal component analysis (PCA) was performed to estimate the interactions among the quantitative real-time RT-PCR data.

RESULTS

The mRNA expression levels of CGRP, VEGF-A, Col2a, Col1a-1, OCN, and NPY in the male mouse rib gradually increased during development. An antisense probe for CGRP mRNA was strongly detected in the central region of the mouse rib at E12.5 and the hypertrophic and ossification zones at E17.5 by in situ hybridization. VEGF-A was also located in the same region as CGRP at E12.5 and E17.5. OPN was strongly detected at the rib formation stage from E14.5 to E17.5. The expression of CGRP also differed between the proximal and distal regions of the rib at E17.5. As demonstrated by in situ hybridization, CGRP continuously participates in cartilage formation in the distal regions of the rib after birth. The PCA revealed that the mRNA expression of CGRP was related to that of Col1a-1 and VEGF-A during rib formation.

CONCLUSION

This study shows that CGRP is involved in vascular and bone formation during rib development and may also be involved in cartilage formation after birth. The findings suggest that CGRP may temporarily participate in bone formation and continuously participate in cartilage formation in the rib, which may also be related to the formation of the anterior thoracic wall after birth.

A case of double inferior vena cava with the connection to sacral venous plexus

Double inferior vena cava (IVC) is known as a variation in which the additional IVC is found on the left side of the abdominal aorta. Their developmental process has been well documented, but the venous development around the lumbosacral region is controversial. In the present double IVC case, the left IVC entered the left renal vein at the L2 level, and the renal veins on each side flowed into the right IVC at the L1 level. The internal and external iliac veins were merged at the S1 level on each side. Besides, a venous communication (3-mm-width) was found horizontally between the internal iliac veins near their origin at the S1 level. It had also an extra narrow branch (1-mm-width), which ran obliquely upward and reached the left IVC at the level of L5. The median sacral artery (MSA) ran at the ventral side of the horizontal communication but at the dorsal side of its extra oblique branch. These results suggest that the oblique branch is a remnant of the anastomosis between the right and left posterior cardinal veins. Furthermore, the horizontal vein corresponds to the sacral venous plexus, suggesting that the anastomosis can be formed between the IVC and sacral venous plexus.

Morphological Observations of the Bony Canal Structure of the Eustachian Tube in Elderly Human Cadavers With Cone-Beam Computed Tomography and Principal Component Analysis

Objective:

Anatomical information regarding the eustachian tube (ET) is limited; therefore, more detailed analytical data on ET structure is needed when planning surgical treatments involving the temporal bone.

Methods:

We examined the bony structure of the middle ear and ET in 30 Japanese donor cadavers (71-97 years old at the time of death) both macroscopically and with cone-beam computed tomography. Each ET was reconstructed in 3 dimensions, and the structure and correlations of ET element measurements, identified via principal component analysis, were analyzed.

Results:

Delineation between bony and cartilaginous zones appeared unclear, and the space between ET cartilage and the carotid canal was narrow. We observed stenosis of the ET bony canal in 43.3% of the specimens (n = 30). In 50% of the specimens, the position of the ET bony canal was depressed at the pharyngeal orifice of the auditory side of the tube, and the middle region was a roundish structure. The lateral and central regions of the bony canal were related to the ET bony canal structure.

Conclusion:

The close proximity of the ET bony canal to the carotid canal is an important anatomical and morphological finding. Pre-surgical 3D modeling of the middle ear structure, or at a minimum, of the central region of the middle ear canal, may provide useful information for planning procedures that involve the ET.

Cytonuclear Estrogen Receptor Alpha Regulates Proliferation and Migration of Endometrial Carcinoma Cells

OBJECTIVE

The effects of estrogen on cells are mediated by the estrogen receptor α (ERα) which localizes at the peri-membrane, cytoplasm, and the nucleus of cells. Therefore, we intended to investigate how cytonuclear ERα plays its roles in different cellular activities.

METHODS

We used amino acid substituted ERα that localized at the cytoplasm and nucleus but has no direct DNA-binding activities. ERα-negative endometrial carcinoma cells (ERα-) were stably transfected with plasmid of human ERα carrying a substituted phenylalanine at position 445 with alanine (ERα-F445A). Treated with 17β-estrogen (E2) or bazedoxifene (BDF), cell proliferation, migration, and expression of kinases related to ERα signal transduction pathways were observed.

RESULTS

E2 (40 nM) significantly activated proliferation in ERα-F445A cells, but not in ERα- cells. Similarly, E2 significantly activated cell migration in ERα-F445A cells, rather than that in ERα- cells. While no obvious change in the amount of the non-phosphorylated mammalian target of Rapamycin (mTOR), the expression of mTOR phosphorylated at serine 2448 decreased, which was recovered in presence of 17β-estrogen (E2) in the ERα-F445A cells. On the other hand, the expression of focal adhesion kinase (FAK) phosphorylated at tyrosine at 297 was attenuated in the ERα-F445A cells treated with E2.

CONCLUSION

It is suggested that the cytonuclear ERα-F445A induces phosphorylation of kinases in downstream pathways, which regulate cell proliferation and migration.

Neonatal maternal separation increases the number of p27-positive Sertoli cells in prepuberty

Neonatal maternal separation (NMS) is an experimental model for early life stress, which affects the growth and development of various organs, resulting in adverse health effects in humans and animals. In our previous study, we demonstrated that NMS [(0.5-, 1-, 2-h/day NMS, from postnatal day (PND) 1-10] induced morphological changes to the male reproductive system, including decreased Sertoli cell numbers in mouse testes at PND 70. To clarify the mechanism by which NMS decreases Sertoli cell numbers, we evaluated the effects of NMS on mouse testes at PNDs 10 and 16. At PND 10, the Sertoli cell number was not significantly different among experimental groups; however, it decreased in 0.5- and 2-h/day NMS mice at PND 16. The termination of Sertoli cell proliferation in prepuberty can be induced by p27, a cyclin-dependent kinase inhibitor. At PND 10, we observed an increase in the number of p27-positive Sertoli cells in 2-h/day NMS mice. The seminiferous tubule diameters decreased significantly in 1- and 2-h/day NMS mice, and the relative interstitial area increased in 2-h/day NMS mice. Serum corticosterone level significantly increased, and serum testosterone level significantly decreased in the 2-h/day NMS mice. At PND 16, the tubule diameters and height of seminiferous epithelium were significantly higher in 0.5- and 2-h/day NMS mice. Our results suggest that NMS disturbs serum corticosterone and testosterone levels and increases the number of p27-positive Sertoli cells at PND 10, resulting in a decrease in the number of Sertoli cells at PND 16.

Heat shock protein A4L is a potent autoantigen for testicular autoimmunity in mice

Experimental autoimmune orchitis (EAO) may be used as a model to investigate immunological infertility in men. Murine EAO is induced via immunization with auto-immunogenic antigens (AIAgs) from testicular germ cells (TGCs). CD4 + T cells play a crucial role in EAO induction. However, whether AIAgs induce an immune response remains unclear. We aimed to identify self-antigens that induce EAO by screening a phage display library of random TGC peptides using IgG from EAO-induced A/J mice. Twenty TGC-specific AIAgs were detected, and G protein-coupled receptor kinase 2 interacting protein-1 (GIT1) and heat shock protein A4L (HSPA4L) were identified as candidate AIAgs that induce EAO. Immunization with GIT1 or HSPA4L, emulsified in complete Freund's adjuvant, resulted in 66 % or 100 % incidence of EAO, respectively, indicating that HSPA4L is a most potent AIAg that induces EAO in mice. These findings may expectedly help improve the diagnostic procedures and treatment of immunological infertility in men.

Comparison of CGRP distributions in the maxillary sinus and trigeminal ganglion between elderly dentulous and edentulous humans

Thickening of the Schneiderian membrane (SM, mucosa of the maxillary sinus) appears in the paranasal sinus. Information on SM thickening is available for patients receiving sinus lift treatments, which is a risk factor for SM excretory dysfunction. However, more information is needed on the structure of the SM and the relationship between the maxilla sinus and palatine with the alveolar bone and the SM for dental implant treatment in the human maxilla. One hundred twenty-six sides of the maxilla from 71 cadavers were subjected to cone-beam computed tomography analysis and macroscopic and immunohistochemical observations in this study. A thickened SM was mainly observed in the middle region of the basal layer of the maxillary sinus (MS). Strong calcitonin gene-related peptide (CGRP)-positive reactions were observed in the alveolar bone, oral mucosa, mucosa of the MS, and trigeminal ganglion (TG) cells in dentulous samples compared with edentulous samples. TG cells play important roles in delivering CGRP through axons to the mucosal gland and in regulating the maxilla-related thickening of the SM. These data could help determine CGRP functions in the mucosal gland and bone formation between dentulous and edentulous samples and indicate that CGRP may pass from the TG to the MS glands.

Effects of the posterior pelvic tilt sitting posture on thoracic morphology and respiratory function

[Purpose] We investigated how differences in pelvic angle in the posterior pelvic tilt sitting posture simultaneously affect the thoracic morphology and the respiratory function. [Participants and Methods] The participants were 18 healthy young males. We positioned the pelvis at 0°, 10°, 20°, and 30° of posterior tilt, following which the thoracic expansion volume ratio, thoracic spine tilt angle, and respiratory function were measured. We calculated the thoracic volume and thoracic spine tilt angle by measuring the amount of displacement of reflective markers attached to the thoracic area using the Vicon MX 3D-analysis system. Respiratory function was measured by spirometry. [Results] The expansion volume ratio decreased significantly in response to 10-30° posterior pelvic tilt sitting at the mid-thorax and 30° posterior pelvic tilt sitting at the lowest thorax. The upper thoracic spine level showed a change in anterior tilt at 10-30° posterior pelvic tilt sitting, whereas the lower thoracic spine level showed a change in posterior tilt at 30° posterior pelvic tilt sitting. Respiratory function was significantly lower at 30° posterior pelvic tilt sitting than at 0° posterior pelvic tilt sitting. A positive correlation between thoracic expansion volume ratio and respiratory function was found at 30° posterior pelvic tilt sitting. [Conclusion] Changes in thoracic spine tilt angle due to posterior pelvic tilt sitting may restrict the expansion of thoracic motion during respiration, thereby affecting respiratory function.

Analysis of the mylohyoid nerve in elderly Japanese cadavers for dental implant surgery

OBJECTIVES

Injury to the mandibular nerve (MN) branches may cause pain and irregular occlusal movement during mastication after mandibular dental treatments. Growing evidence indicates that the calcitonin gene-related peptide (CGRP) plays a key role in the development of peripheral sensitization and the associated enhanced pain, suggesting it may be a sign to ensure a safe and reliable dental implant treatment. Our focus was on the distribution of the MN branches and their communication with the lingual nerve (LN), the localized expression of CGRP, and the identification of a pain area related to the mylohyoid muscle (MM) fascia in the mandibular floor.

MATERIAL AND METHODS

In this study, MM samples from 440 sides of 303 human cadavers aged 61-103 years were examined microscopically and immunohistochemically. These data were further evaluated by the use of principal component analysis.

RESULTS

A complex but weak attachment site was identified for the fascia of the MM. CGRP expression was mainly located in small vessels and was scattered throughout the whole fascia of the MM. Communication between the MN and LN was found in 62.5% (275/440) of the samples. The results from the principal component analysis showed that the positive contributions were from the descending branch in the premolar region (correlation coefficient value R = 0.665), the ascending branch in the molar region (R = 0.709) and the intermediate branch of the digastric branch (R = 0.720) in component 1. In the fascia off the MM, strongly labeled CGRP-positive cells were also found around the blood vessels and the nerve.

CONCLUSIONS

The findings reported in this study indicate that there is a risk of damage when pulling the fascia off the MM at the border of the molar and premolar regions during dental implant surgery.

Common hepatic artery originating from superior mesenteric artery with replaced right hepatic artery

We found a variational case relating to the arteries distributed to the liver and pancreas during the routine cadaver dissection course. The common hepatic artery originated from the superior mesenteric artery as the first branch. The common hepatic artery was soon divided into the left and right hepatic arteries and distributed to the left and right lobe of the liver. The superior pancreaticoduodenal artery arose from the gastroduodenal artery, a branch of the left hepatic artery. The inferior pancreaticoduodenal artery originated from the superior mesenteric artery. Besides, two posterior branches of the right hepatic artery supplied the duodenum and the head of the pancreas. The arterial arcades were formed behind the head of the pancreas among the superior pancreaticoduodenal artery and these two posterior branches of the right hepatic artery. In conclusion, this case can be considered a rare case in which the replaced common hepatic artery and replaced right hepatic artery occurred simultaneously. The coexisting of these two replaced arteries suggests that the developmental processes to form these variations are independent.

Characteristics of Mandibular Canal Branches Related to Nociceptive Marker

It is difficult to correlate the direction of mandibular canal branches (MCBs) with altered sensation in dental treatments. In contrast, calcitonin gene-related peptide (CGRP) is related to vasodilation, bone formation, and the interaction with the peripheral nervous system. Therefore, we investigated the detailed morphological characteristics of MCBs using cone-beam computed tomography (CBCT) and observation of the CGRP distribution around the MCB. The MCB measurements were evaluated using principal component analysis (PCA) to identify morphological correlations. A total of 168 sides of mandibles from 84 cadavers were analyzed in this study. Most of the MCBs were primarily in the direction of the clock model from X to XI in sagittal sections and XII to I in coronal sections of the mandible. The structure of the MCB was divided into the fine canal branch (60.4%, 223/369), partial branch (24.4%, 90/369), and no canal branch (15.2%, 56/369). PCA indicated that the measurement element with the MCB and its structures were correlated in contrast to tooth factors. Positive CGRP reactions were clearly observed in the no-canal branch group compared to other groups. These data provide useful suggestions for MCB dynamics and information for clinical dental treatment.

Neonatal maternal separation causes decreased numbers of sertoli cell, spermatogenic cells, and sperm in mice

Neonatal maternal separation is an experimental model used to evaluate the effects of toxic stress in neonates, or early life stress. Although various physiological and psychological stresses during childhood have been reported, the effects of neonatal maternal separation on the male reproductive system remain unclear. Therefore, the present study evaluated the effects of neonatal maternal separation on the male reproductive system. In neonatal male ICR mice, maternal separation was performed for 0.5, 1, 2, and 4 hours/day, from postnatal day 1 to 10. At 10 weeks of age, the neonatal maternal separation mice exhibited decreases in both testicular weight and epididymal sperm number, along with various testicular morphological changes involving germ cells, Sertoli cells, and interstitial cells. Notably, neonatal maternal separation mice showed decreased numbers of Sertoli cells. Animals subjected to 0.5-, 1-, and 2-h/day neonatal maternal separation exhibited decreases in serum levels of testosterone but not in those of gonadotropin (luteinizing hormone and follicle-stimulating hormone). Together, these data showed that neonatal maternal separation in male mice causes decreased Sertoli cell numbers following puberty, resulting in subsequent decreased spermatogenic activity.

Pelvic collateral pathway during endovascular aortoiliac aneurysm repair with internal iliac artery interruption: a retrospective observational study

BACKGROUND

Ipsilateral branches of the deep femoral artery (DFA) are qualitatively identified as collateral arteries based on angiography after internal iliac artery (IIA) interruption. The purpose of this study was to quantitatively identify the major collateral pathway after unilateral IIA interruption during endovascular aortoiliac aneurysm repair to preserve the pelvic circulation and reduce the risk of ischemic complications.

METHODS

The study population included 28 patients (mean age 76.3 years) with aortoiliac aneurysm who underwent endovascular aneurysm repair with unilateral IIA interruption from August 2012 to January 2020. The diameters of the bilateral preoperative and postoperative DFA, lateral femoral circumflex artery (LFCA), medial femoral circumflex artery (MFCA) and obturator artery (ObA) were measured on contrast-enhanced computed tomography using a 3-dimensional image analysis system. The measured values were evaluated and analyzed with a repeated measures two-way analysis of variance and Dunnett's test.

RESULTS

The postoperative diameters of the MFCA (P = 0.051) and ObA (P = 0.016) were observed to be larger than the preoperative diameters. Such increases in the MFCA (P < 0.001) and ObA (P < 0.001) diameters were only found to be significant on the unilateral side of the IIA interruption, and the diameter of the ipsilateral LFCA (P < 0.001) was also found to have significantly increased in size. However, no significant arterial extension was found on the contralateral side.

CONCLUSIONS

The ipsilateral MFCA-ObA pathway might therefore be a major collateral pathway arising from the DFA to preserve pelvic circulation after unilateral IIA interruption.

The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting

The purpose of this study was to assess the usefulness of saturated salt solution-embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half-day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self-confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed-rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self-assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution-embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well-preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution-embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.

Phase control of a z-current-driven plasma column

A dynamic mitigation is presented for sausage and kink instability growths of a z-current-driven magnetized plasma column. In this Rapid Communication we found that a wobbling motion of the z-current electron axis induces a phase-controlled perturbation, so that the growths of the sausage and kink instabilities are successfully and remarkably mitigated. In general, plasma instabilities emerge from perturbations, and the perturbation phase is normally unknown. However, if the perturbation phase is known or actively imposed by, for example, a designed driver wobbling behavior, the instability growth would be controlled and mitigated by a superimposition of the perturbations imposed. The results in this Rapid Communication demonstrate that the wobbling z-current electron beam would provide an improvement in the plasma column stability and uniformity.

Immunohistochemical study for relationship between vessel and lymphatic properties and tooth marks in human oral mucosa

Angiogenesis is an important issue related to normal growth and differentiation, and it is a critical issue in the progression of human disease in oral mucosa. Tooth marks occur after clenching the teeth for a long period under muscle tension in the human oral cavity. However, the sites of angiogenesis, cell differentiation and microvessel density are not known for human mucosa with tooth marks. Therefore, we investigated the relationship between the markers of differentiation (Ki-67), angiogenesis (CD31, D2-40, VEGF-A), and marks from teeth in the second molar region using immunohistochemical methods. In addition, we compared these areas with the mucous membrane. Our results revealed blood and lymphoid vessels in irregular mucosa structures, and the vessels in the oral mucosa were observed in three types of samples: dentulous, denture attachment (containing partial teeth), and edentulous samples. The localization of the angiogenesis was related to the structure of the oral mucosa of connective tissue in humans, such as the mucosal fold-like of the buccal region. Using principal component analysis (PCA), we found that tooth occlusal condition, gender, anti-VEGF-A reaction levels in oral mucosa of the epithelium were positive factors in all groups, which is in contrast to the negative association of Ki-67 reaction in the epithelium and CD31 expression. In addition, Ki-67 reaction in oral mucosa had negative impacts, in contrast to the positive association of D2-40. These PCA properties provide useful information for future study of tumour progression or mechanical stress in remodelling of oral mucosa and angiogenesis. Moreover, mechanical stress of the occlusal condition may be correlated with tumour angiogenic activity and cell differentiation in human oral mucosa.

Humeral Head Morphometry Can Predict the Presence of Subacromial Spurs: Measurements of Dried Bones from Human Shoulder Girdles

OBJECTIVE

To clarify the relationship between the morphological characteristics of the bones of the shoulder girdle and the presence of subacromial spurs (SS).

METHODS

The bones of 36 cadaveric shoulder girdles were measured. After dividing the bone specimens into SS present and absent groups, various bone parameters between the two groups were statistically compared. Logistic regression analysis was conducted to assess the significance of each parameter as a predictor of SS formation. A receiver operating characteristic curve analysis was used to determine the cut-off point and to assess the sensitivity and specificity of the parameters showing significant differences.

RESULTS

SS were found in 16 scapulae. The values for five parameters of the examined shoulder girdles were significantly different between the two groups. The presence of SS depended on the humeral head ratio, which was calculated by dividing the length of the greater tubercle of the humerus by the length of the lesser tubercle. A cut-off value of 1.97 was suitable for discriminating between the presence and absence of SS (sensitivity, 75%; specificity, 80%).

CONCLUSION

The presence of SS is related to several morphological characteristics of the shoulder girdle and, the presence of SS can be predicted using humeral head morphometry.

Peculiar behavior of Si cluster ions in a high-energy-density solid Al plasma

Peculiar behavior is found in a Si cluster ion, moving with a speed of ∼0.22c (c: speed of light) in a solid Al plasma in the context of cluster-ion beam driven inertial confinement fusion: The Si ion, moving closely behind the forward-moving Si ion for a distance of several Å in the cluster, feels the wake field generated by the forward Si. The acceleration interaction force on the rear Si ion by the forward-moving ion may balance with the deceleration backward force in the longitudinal-moving direction. The forward-moving Si ion would be decelerated, as an isolated ion is decelerated without correlation. However, the deceleration of the rear Si ion, moving behind closely, would be reduced significantly. The rear Si ion may catch up and overtake the forward-moving Si ion in the cluster during the Si cluster-ion interaction with the high-density Al plasma. This peculiar behavior appears when the ions are aligned well longitudinally. The wake field is confined around the Si ion in the forward and transverse directions for a distance smaller than the Si cluster interionic distance l_{c}. However, the tail of the wake field extends beyond l_{c} due to the Si ion high speed of ∼0.22c. Therefore, the peculiar behavior shown above appears only for the ions in one cluster aligned well longitudinally.

Advanced cadaver-based educational seminar for trauma surgery using saturated salt solution-embalmed cadavers

Aim

Senior surgeons in Japan who participated in "cadaver-based educational seminar for trauma surgery (CESTS)" subsequently stated their interest in seminars for more difficult procedures. Therefore, we held a 1-day advanced-CESTS with saturated salt solution (SSS)-embalmed cadavers and assessed its effectiveness for surgical skills training (SST).

Methods

Data were collected from three seminars carried out from September 2015 to January 2018, including a 10-point self-assessment of confidence levels (SACL) questionnaire on nine advanced surgical skills, and evaluation of seminar content before, just after, and half a year after the seminar. Participants assessed the suitability of the two embalming methods (formalin solution [FAS] and SSS) for SST, just after the seminar. Statistical analysis resulted in P < 0.0167 comparing SACL results from seminar evaluations at the three time points and P < 0.05 comparing FAS to SSS.

Results

Forty-three participants carried out surgical procedures of the lung, liver, abdominal aorta, and pelvis and extremity. The SACL scores increased in all skills between before and just after the seminar, but were decreased by half a year after. However, SACL scores of each skill did not change significantly, except for external fixation for pelvic fracture at just after and half a year after. The SSS-embalmed cadavers were evaluated as being more suitable than FAS-embalmed cadavers for each procedure.

Conclusions

Advanced-CESTS using SSS-embalmed cadavers increased the participants' self-confidence just after the seminar, which was maintained after half a year in each skill, except external fixation for pelvic fracture. Therefore, SSS-embalmed cadavers are useful for SST, particularly for surgical repairs.

Spraying urea solution reduces formaldehyde levels during gross anatomy courses

Formaldehyde (FA) is frequently used to embalm human cadavers that are employed to teach gross anatomy to medical and dental students. However, exposure to FA is harmful to both students and educators. The aim of this study was to reduce the FA levels in the anatomy dissection hall by spraying an FA scavenger solution. We measured the changes in FA levels after administering FA scavenger solutions to liquid, wet paper towels, organs, and cadavers containing FA. Among L-cysteine, N-ethyl urea, and urea, the latter was found to have the strongest scavenging power towards the FA in the liquid. The molar concentration of urea that most efficiently reduced the levels of volatilized FA from the wet paper towels was the same as that of the FA. After spraying the urea solution, the volatilized FA levels immediately decreased, reaching their minimum at 60 min, and remained low even after 240 min. Spraying the urea solution onto the organs reduced the levels of FA volatilized from the surfaces of organs but not those from the insides of the organs. In the dissection hall used for the gross anatomy course at Tokyo Medical University, the FA levels were significantly decreased after spraying the urea solution onto the cadavers. Moreover, dissection could be performed without the cadavers putrefying during the 4-month course. These results indicate that various institutes could use urea solution spray to effectively reduce the FA levels in the dissection hall and thus ensure the safety of students and educators.

Using Artificial DNA Sequence to Suppress Non-specific Bindings in Crude Nuclear Extract During Surface Plasmon Resonance Assay

OBJECTIVE

Surface plasmon resonance (SPR) has been extensively used to characterize the interactions between molecules in terms of their binding specificity, affinity, and kinetics. Practical procedures, however, for measurement of the protein-DNA association in crude nuclear extract are yet to be defined.

METHODS

Crude nuclear extract was obtained from MCF-7 cells or recombinant estrogen receptor alpha (ERα) was used for analysis. To suppress signal from non-specific bindings in SPR assay using Biacore, DNA fragments with minimal protein binding activity were identified in a database for transcription factors and included in the study.

RESULTS

It is known that when analytes were purified transcription factors, the dissociation curves in Biacore sensorgrams exhibit exponential tendency. Based on statistical analysis, the dissociation phase between the ERα complex from crude nuclear extract and DNA oligonucleotides could be fitted exponentially. Following extrapolation of the dissociation phase, theoretical amount of bound antibodies could be estimated and compared for significant difference.

CONCLUSION

Our procedures made SPR technique such as Biacore a practical technique for measurement of protein-DNA associations in crude nuclear extract with reproducible and reliable results.

Positional relationships of abdominal aortic branches for contrast radiography of the inferior mesenteric artery using the coeliac trunk and superior mesenteric artery as landmarks

PURPOSE

To establish a method by which angiography of the inferior mesenteric artery (IMA) can be performed smoothly, we investigated the relative locations of the coeliac trunk (CT), superior mesenteric artery (SMA), IMA, and left renal artery (LtRA).

METHODS

From a total of 60 cadavers, 32 cadavers with few arteriosclerotic lesions and little vascular tortuosity were selected for the study. The abdominal aorta (Ao) were removed and incised on both lateral side, along the vertical axis and transected into the ventral and dorsal sides. The intravascular lumen on the ventral side of the Ao was photographed using a digital camera, and the horizontal and vertical diameters of the sites of confluence of the CT, SMA, and IMA, were measured on the computer screen. We also calculated the distances between the branches, including the CT, SMA, IMA, LtRA, and the common iliac artery (CoI).

RESULTS

Although the SMA-IMA distance did not correlate with the CT-SMA distance, the ratio of the SMA-IMA to CT-CoI distance was four times greater than the ratio of the CT-SMA to CT-CoI distance.

CONCLUSIONS

The site of branching of the IMA can be inferred to some extent from the CT and SMA distance.

Anatomical relation between the accessory process and pedicle in the lumbar vertebrae

The pedicle screw is one of the most common medical devices used in spinal surgery. Although there are well-established insertion points based on anatomical landmarks, such as the mammillary process and the transverse process, morphological data on the relationship between the accessory process and the pedicle are still scarce. To clarify this relationship, we recruited 50 cases of hernia of lumbar intervertebral disc, diagnosed using three-dimensional computed tomography of the lumbar vertebrae. We identified the pedicle isthmus in a transverse plane parallel to the upper endplate and measured the angles and distances from the tip of the accessory process to the intersection points at the medial or lateral surface, or at the midpoint between the two intersection points. In a sagittal plane showing the pedicle isthmus, we measured the wedging angle of the vertebral body as well as the angle from the tip of accessory process to the posterior edge of the upper endplate of vertebral body, or to the lower end of the pedicle root. We found that from the tip of the accessory process passing through the pedicle isthmus, a line should be directed 20 (± 6.6) degrees medially in the transverse plane and 5 (± 4.3) degrees cranially in the sagittal plane. This distance from the tip of the accessory process to the isthmus was 1.5 (± 0.3) cm. Our study provides a new anatomical basis for the use of the accessory process as a landmark for insertion of the pedicle screw.

Anatomical etiology of "pseudo-sciatica" from superior cluneal nerve entrapment: a laboratory investigation

Objective

The superior cluneal nerve (SCN) may become entrapped where it pierces the thoracolumbar fascia over the iliac crest; this can cause low back pain (LBP) and referred pain radiating into the posterior thigh, calf, and occasionally the foot, producing the condition known as “pseudo-sciatica.” Because the SCN was thought to be a cutaneous branch of the lumbar dorsal rami, originating from the dorsal roots of L1–L3, previous anatomical studies failed to explain why SCN causes “pseudo-sciatica”. The purpose of the present anatomical study was to better elucidate the anatomy and improve the understanding of “pseudo-sciatica” from SCN entrapment.

Materials and methods

SCN branches were dissected from their origin to termination in subcutaneous tissue in 16 cadavers (5 male and 11 female) with a mean death age of 88 years (range 81–101 years). Special attention was paid to identify SCNs from their emergence from nerve roots and passage through the fascial attachment to the iliac crest.

Results

Eighty-one SCN branches were identified originating from T12 to L5 nerve roots with 13 branches passing through the osteofibrous tunnel. These 13 branches originated from L3 (two sides), L4 (six sides), and L5 (five sides). Ten of the 13 branches showed macroscopic entrapment in the tunnel.

Conclusion

The majority of SCNs at risk of nerve entrapment originated from the lower lumbar nerve. These anatomical results may explain why patients with SCN entrapment often evince leg pain or tingling that mimics sciatica.

Anatomical study of middle cluneal nerve entrapment

Object

Entrapment of the middle cluneal nerve (MCN) under the long posterior sacroiliac ligament (LPSL) is a possible, and underdiagnosed, cause of low-back and/or leg symptoms. To date, detailed anatomical studies of MCN entrapment are few. The purpose of this study was to ascertain, using cadavers, the relationship between the MCN and LPSL and to investigate MCN entrapment.

Methods

A total of 30 hemipelves from 20 cadaveric donors (15 female, 5 male) designated for education or research, were studied by gross anatomical dissection. The age range of the donors at death was 71–101 years with a mean of 88 years. Branches of the MCN were identified under or over the gluteus maximus fascia caudal to the posterior superior iliac spine (PSIS) and traced laterally as far as their finest ramification. Special attention was paid to the relationship between the MCN and LPSL. The distance from the branch of the MCN to the PSIS and to the midline and the diameter of the MCN were measured.

Results

A total of 64 MCN branches were identified in the 30 hemipelves. Of 64 branches, 10 (16%) penetrated the LPSL. The average cephalocaudal distance from the PSIS to where the MCN penetrated the LPSL was 28.5±11.2 mm (9.1–53.7 mm). The distance from the midline was 36.0±6.4 mm (23.5–45.2 mm). The diameter of the MCN branch traversing the LPSL averaged 1.6±0.5 mm (0.5–3.1 mm). Four of the 10 branches penetrating the LPSL had obvious constriction under the ligament.

Conclusion

This is the first anatomical study illustrating MCN entrapment. It is likely that MCN entrapment is not a rare clinical entity.

Development of heterotopic transplantation of the testis with the epididymis to evaluate an aspect of testicular immunology in rats

Transplantation of testicular cells and tissues has been studied for the investigation of immunology of the testis, which is an immunologically privileged organ. However, reports of transplant of the testis at organ level have been extremely limited because of technical difficulties of the orthotopic testis transplantation (OTT) in experimental animals. In the present study, we developed a new and simple model of the heterotopic testis transplantation (HTT), which is donor testis transplantation into the cervical region of recipients, in a syngeneic model in rats [donor Lewis (LEW) graft to LEW recipient]. The duration of HTT was significantly shorter and success rate higher than that of OTT. To histologically evaluate HTT, the local immune responses were compared among the syngeneic model, an acute rejection allogeneic model [donor Augustus Copenhagen Irish (ACI) graft to LEW recipient] and a chronic rejection allogeneic model (donor F344 graft to LEW recipient) at postoperative day 3. We found that allogeneic ACI grafts resulted in mild and not severe orchitic lesions, whereas immune responses of allogeneic F344 grafts seemed intact and were not significantly different from those of syngeneic LEW grafts. These results suggest that our new operative procedure will be useful in future for the investigation of the testicular immunology.

A novel classification of musculocutaneous nerve variations: The relationship between the communicating branch and transposed innervation of the brachial flexors to the median nerve

The musculocutaneous nerve innervates the brachial flexors; i.e., the coracobrachialis, biceps brachii, and brachialis. The musculocutaneous and median nerve sometimes share a communicating branch and also muscular branches to brachial flexors are sometimes transposed to median nerve. Because these variations constitute a potentially important clinical and surgical issue, we evaluated 130 upper limbs of 65 cadavers and 184 cases of musculocutaneous and median nerve variations in the literature and devised a novel system of classification that covers each pattern of variation. Our proposed classification was applicable in all of our cases and those previously reported. In addition, transposed innervation of the brachial flexors from the musculocutaneous nerve to the communicating branches was observed in one limb in our case series. In this case and all previously reported cases of transposed innervation of the brachial flexors, communicating branches between the musculocutaneous and median nerve were found and no brachial flexor branch arose from the musculocutaneous nerve distal to the communicating branches. Consequently, we established that, as per our novel classification, all patterns of communicating branches could be classified into five types and the patterns of transposed innervation of the brachial flexors into three types.