Biofluorescent sexual dimorphism revealed in a southern Appalachian endemic salamander, Plethodon metcalfi.

Biofluorescence occurs when a living organism absorbs high energy light and reemits it at longer wavelengths. Many species within clades of vertebrates are known to fluoresce including mammals, reptiles, birds, and fish. Most, if not all, amphibians exhibit biofluorescence when exposed to either blue (440-460 nm) or ultra-violet (360-380 nm) wavelengths of light. Salamanders (Lissamphibia: Caudata) appear to consistently fluoresce in green wavelengths (520-560 nm) when excited by blue light. Biofluorescence is theorized to have many ecological functions including mate signaling, camouflage, and mimicry. Despite the discovery of their biofluorescence, its role in salamander ecology and behavior remains unresolved. In this study we present the first case of biofluorescent sexual dimorphism within Amphibia and the first documentation of the biofluorescent pattern of a salamander within the Plethodon jordani species complex. This sexually dimorphic trait was discovered in the southern Appalachian endemic species, Southern Gray-Cheeked Salamander (Plethodon metcalfi, Brimley in Proc Biol Soc Wash 25:135-140, 1912), and may extend into other species within the Plethodon jordani and Plethodon glutinosus species complexes. We propose that this sexually dimorphic trait could be related to fluorescence of ventral modified granular glands used in plethodontid chemosensory communication.

In vitro and in vivo validation of a new three-dimensional fringe projection-based device (AEVA-HE) dedicated to skin surface mapping.

BACKGROUND: Aging signs are much visible on the surface of the skin that presents different changes: cheeks start to sag, more and deeper wrinkles appear, and pigmentation spots increase. Face diagnostic to recommend products includes assessing cutaneous micro-relief or the micro-depressive network on the face. Furthermore, there is an increasing demand for clinical and instrumental methods to prove the efficacy of anti-aging treatments. As a result, very accurate and sensitive three-dimensional (3D) devices are developed and validated to measure and quantify aging skin and to catch fine anti-aging products acting on wrinkles and fine lines. METHODS: AEVA-HE, a non-invasive 3D method based on fringe projection technology, is used to robustly characterize the skin micro-relief from a full-face acquisition and from multiple extracted zones of interest. In vitro and in vivo studies are conducted to assess the reproducibility of this system and its precision toward a standard fringe projection system, DermaTOP. RESULTS: The AEVA-HE successfully measured micro-relief and wrinkles and demonstrated the reproducibility of measurements.  AEVA-HE parameters were found highly correlated to DermaTOP. CONCLUSION: The present work illustrates the performance of the AEVA-HE device and its dedicated software kit as a precious tool for quantifying the major characteristics of wrinkles appearing with age and thus offers a high potential for assessing the effect of anti-wrinkling products.

Cross-tissue correlations of genome-wide DNA methylation in Japanese live human brain and blood, saliva, and buccal epithelial tissues.

Neuroepigenetics considers genetic sequences and the interplay with environmental influences to elucidate vulnerability risk for various neurological and psychiatric disorders. However, evaluating DNA methylation of brain tissue is challenging owing to the issue of tissue specificity. Consequently, peripheral surrogate tissues were used, resulting in limited progress compared with other epigenetic studies, such as cancer research. Therefore, we developed databases to establish correlations between the brain and peripheral tissues in the same individuals. Four tissues, resected brain tissue, blood, saliva, and buccal mucosa (buccal), were collected from 19 patients (aged 13-73 years) who underwent neurosurgery. Moreover, their genome-wide DNA methylation was assessed using the Infinium HumanMethylationEPIC BeadChip arrays to determine the cross-tissue correlation of each combination. These correlation analyses were conducted with all methylation sites and with variable CpGs, and with when these were adjusted for cellular proportions. For the averaged data for each CpG across individuals, the saliva-brain correlation (r = 0.90) was higher than that for blood-brain (r = 0.87) and buccal-brain (r = 0.88) comparisons. Among individual CpGs, blood had the highest proportion of CpGs correlated to the brain at nominally significant levels (19.0%), followed by saliva (14.4%) and buccal (9.8%). These results were similar to the previous IMAGE-CpG results; however, cross-database correlations of the correlation coefficients revealed a relatively low (brain vs. blood: r = 0.27, saliva: r = 0.18, and buccal: r = 0.24). To the best of our knowledge, this is the fifth study in the literature initiating the development of databases for correlations between the brain and peripheral tissues in the same individuals. We present the first database developed from an Asian population, specifically Japanese samples (AMAZE-CpG), which would contribute to interpreting individual epigenetic study results from various Asian populations.

The Five Ds for Safe and Effective Buccal Fat Removal.

SUMMARY: An aesthetically sculpted malar, cheek, and jawline contour is a desirable feature sought out by many adults with central facial adiposity. This fullness, anterior to the masseter, can be attributed to underlying buccal lipodystrophy. An attractive central facial concavity can be delivered by performing buccal fat pad excision in conjunction with malar fat pad augmentation and mandibular contouring if indicated. Appropriate patient selection is critical for preventing an aged or unnatural appearance. The authors present a safe and reliable five-step technique for buccal fat pad excision: the Five Ds.

Development and Validation of a Photonumeric Scale for Evaluation of Infraorbital Hollowing.

BACKGROUND: The infraorbital hollow is characterized by a sunken hollowing appearance of the junction between the lower eyelid and the cheek. Dermal fillers provide a suitable option to reduce the appearance of infraorbital hollowing. To objectively evaluate treatmentrelated improvements in clinical practice and research, a validated photonumeric scale is needed. OBJECTIVE: To present the scale development methods for the Merz Infraorbital Hollow Assessment Scale and establish its reliability and clinical relevance. METHODS: A 5-point photonumeric scale was developed to objectively assess the infraorbital hollowing among subjects of varying sex, age, and skin type. Intra- and inter-rater reliability was evaluated using live assessments conducted 2 weeks apart. The clinical relevance of a 1-point difference in scale-severity grade was evaluated through side by-side comparisons of photographs with either same grade or a one-grade difference. RESULTS: The scale demonstrated excellent reliability when used by trained physicians and other healthcare practitioners. Intra-rater agreement between the 2 live-subject rating sessions was nearly perfect. Substantial inter-rater agreement between the raters from both live sessions was also demonstrated. The mean absolute difference (95% confidence interval) in scale ratings was 1.08 (1.02, 1.14) for "clinically different" pairs and was 0.34 (0.27, 0.41) for "clinically same" pairs, suggesting a 1-point difference is clinically relevant. CONCLUSION: The Merz Infraorbital Hollow Assessment Scale is a validated, reliable, and clinically relevant photonumeric scale for rating infraorbital hollowing. The scale maintains its validity and reliability with reproducible results across a diverse group of males and females of various ages and Fitzpatrick Skin Types. J Drugs Dermatol. 2023;22(1):74-81.doi:10.36849/JDD.7191.

Histological characteristics of macrodontic cheek teeth of guinea pigs.

Macrodontia is the enlargement of tooth dimensions of different ethologies. This work aims to show a histological evaluation of macrodontic teeth in guinea pigs. The material was obtained from animals postmortem. Ninety structural changes derived from 24 guinea pigs were evaluated. All teeth used in the study showed macrodontic changes. The samples were decalcified, dehydrated and embedded in paraffin. Material was cut in the transverse and longitudinal planes in relation to the alveolar bone. Histological evaluation included apical bud cells, pulp cavity cells, periodontium, dentin, enamel, cementum and alveolar bone tissue. Individual elements were evaluated with respect to their morphology and distribution. Moreover, the arrangement of the individual hard tooth structures was assessed on the teeth. No atypia was found among the cells that make up the apical bud, pulp or periodontal cavity. Displacement of periodontal cells or odontoblasts towards the pulp cavity as well as disorganization of the cell system in the pulp cavity were observed. Changes in the dentine ligaments and the reconstruction of the alveolar bone were also observed in areas where dentine and cement systems were affected. Dental slides were observed and showed that the enamel is also involved in structural remodelling of the pulp cavity. The histological assessment revealed that structural changes in macrodontic teeth involve the rearrangement of typical tooth tissues.

Transconjunctival Lower Eyelid Blepharoplasty with Volume Augmentation for Correction of the Lower Eyelid and Cheek Junction.

Aesthetic surgical management of the inferior periorbital region should include an approach to volume augmentation of the midface and infraorbital hollow, reduction of fat pseudoherniation in the lower eyelids, and treatment of the overlying skin. A combined approach using volume augmentation with fat grafting, a transconjunctival approach to the lower eyelid fat pads, and conservative management of the lower eyelid skin can produce optimal aesthetic results while minimizing complications. Fat harvest from the thigh and abdominal region allows for ample grafting material to the lateral cheek, midface, and orbital rim. The treatment paradigm is to restore volume optimally while minimizing fat resection in the lower eyelids. Volume augmentation is used to restore youthful contours, as well as to counter deflation and laxity in the periorbital and midfacial regions.

Odontogenic-like neoplasms of the rabbit cheek: pathological features and comparison to cutaneous trichoblastoma and jaw-associated ameloblastoma.

Odontogenic neoplasms demonstrate unique histopathological features and are thought to arise from the germinal tissues of the developing tooth germ, effectively restricting their anatomic origin to the tooth-bearing regions of the jaw and directly associated soft tissues of the oral cavity. Ectopic odontogenic-like neoplasms located in the skin of cats, rabbits, and human beings challenge these assumptions. Here we describe the clinical, pathological, and immunohistochemical features of 6 spontaneously occurring odontogenic-like neoplasms arising in the cutaneous tissue of the cheek in client-owned pet rabbits, including ameloblastoma-like (n = 3), ameloblastic fibroma-like (n = 2), and ameloblastic carcinoma-like neoplasms (n = 1). Microscopically, all the cheek tumors featured neoplastic epithelium exhibiting odontogenic architectural structures (plexiform ribbons, anastomosing trabeculae, follicles, cysts, and irregular structures with rounded botryoid protuberances) and 1 or more cardinal odontogenic epithelial features (basal palisading, antibasilar nuclei, and central stellate reticulum-like cells). The pancytokeratin, cytokeratin 5/6, cytokeratin 14, and vimentin immunohistochemical patterns of these odontogenic-like lesions were most similar to those of jaw-associated ameloblastoma and differed from those of cutaneous trichoblastoma. All neoplasms were narrowly excised, and for lesions with clinical follow-up information, none had evidence of recurrence 1-7 months after surgical removal. Although evidence suggests that these odontogenic-like tumors of the rabbit cheek may be derived from ectopic rests of transformed tooth germ, the histogenesis of these lesions remains unresolved.

A Review of Midface Aging.

PURPOSE: To review and summarize studies on the anatomy and involutional changes of the midface. METHODS: A PubMed search was performed searching for studies on the anatomy and involutional changes concerning the midface. RESULTS: The anatomy of the midface is complex. Studies of involutional change vary in scientific quality and have conflicting results. However, it appears that among the more common changes, there is a decrease in the maxillary and pyriform angle, with changes to the orbital floor position. Further, there appears to be an inferior migration of the fat compartments of the midface during aging, exacerbating the hollow of the palpebromalar groove and causing a deepening of the nasojugal groove. Changes to the volume of the buccal extension of the buccal fat pad exacerbate these changes and contribute to the gestalt changes associated with facial aging. Here, we review the major characteristics of soft tissue and bony changes on the midface, with special reference to their anatomic relationships. CONCLUSIONS: The major findings characterizing midface aging are related largely to the soft tissue. However, more robust studies are required to quantify these changes and to appraise their impact on the overall manifestation of aging.

Practice patterns for positive sentinel lymph node in head and neck melanoma.

BACKGROUND: An international survey was conducted to investigate the preferences for completion lymph node dissection (CLND) in head and neck melanomas. METHODS: A questionnaire was sent through the American Society of Head & Neck Surgery (AHNS) and Canadian Society of Otolaryngology-Head and Neck Surgery (CSO). RESULTS: Hundred and forty-nine surgeons completed the survey. Response rate was 6.3% and 9.7% from AHNS and CSO members, respectively. When presented the scenario of a 47-year-old male with a clinical T3bN0 cheek melanoma, with 1/1 positive sentinel lymph node (SLN) with nodal deposit <2 mm, 72 of respondents (48.3%) would perform a CLND. Reasons for CLND included multiples positive SLN (64.1%), size of nodal deposits (54.2%), and perceived lack of compliance to follow-up (54.2%). Surgeons with access to immunotherapy treatment were less likely to recommend CLND (p = 0.025). CONCLUSIONS: Following SLN biopsy, nearly half of the surveyed head and neck surgeons would recommend CLND, which contrasts with the current melanoma practice patterns in other anatomic locations. However, compared with an earlier study in the literature it does seem that there has been a shift away from completion neck dissection. Further investigation into understanding practice variations is warranted.

Behavioral Signs Associated With Equine Cheek Tooth Findings.

Equine dental diseases are often underdiagnosed and their signs inadequately reported. Many horse owners have difficulties in recognizing pain-related behavioral signs and in associating them with dental pain. Our objective was to determine what type and degree of dental findings may cause behavioral signs associated with dental pain. In this cross-sectional study, dental examination was performed on 183 adult horses and cheek tooth findings were scored. Owners filled in an internet-based questionnaire including 35 questions concerning eating behavior, bit behavior, and general behavior of the horse. Descriptive statistics and logistic regression analyses were performed. Broadened or darkened fissures [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.04-5.7), complicated fractures (OR 2.3, CI 1.01-5.2) and secondary dentine defects of at least the second degree (OR 3.1, CI 1.2-7.7) were associated with the expression of at least five behavioral signs in the univariable binomial logistic regression analyses. Horses with at least one of these potentially painful cheek tooth findings expressed more signs related to eating behavior, bit behavior, and general behavior than did the other horses. The results suggest that cheek tooth findings indicated by this study as being potentially painful, i.e. broadened or darkened fissures, complicated fractures and secondary dentine defects of at least the second degree, may require intervention, particularly if the horse expresses any behavioral signs that might be related to dental pain.

A primary small cell neuroendocrine carcinoma (SCNC) of the oral cavity (cheek mucosa): Description of a case report.

BACKGROUND: Small cell neuroendocrine carcinoma (SCNC) of the oral cavity is a poorly differentiated, high-grade and very aggressive tumor with a poor prognosis. CASE DESCRIPTION: A 64-year-old, Caucasian, smoker man consulted for an ulcero-necrotic, exophytic, lesion of the right retromolar trigone. Haed&neck CT scan showed a right tonsillar tumor lesion. The 18F-PET scan confirmed the presence of a right, highly hypermetabolic tonsillar lesion and two homolateral, cervical lymph nodes. Histology and immunohistochemistry were consisted with the diagnosis of a primary SCNC of the oral cavity. As the tumor was locally advanced and unresectable, the patient underwent a definitive radio-chemotherapy with a cisplatin/etoposide combined regimen (4 cycles). The treatment was well tolerated and led to a complete tumor response. CONCLUSION: The particularity of this case relies on the rarity of the oral SCNC, its difficult and challenging diagnosis, and the complexity of its management that is not validated by large clinical trials, data being extrapolated from small cell lung cancer. In our case, the patient presenting a locally advanced tumor was treated by a combined radio-chemiotherapy leading to a complete tumor regression. The patient's follow up is too short to assess the real benefit of this treatment on overall survival.

[Morsicatio related white lesions of the tongue borders and lower lip: a case report]. / Witte veranderingen van de onderlip en de tongranden als gevolg van morsicatio.

A 28-year-old woman was referred by her dentist to an oral and maxillofacial surgeon for white lesions of the lower lip and lateral tongue borders on both sides. The diagnoss morsicatio labiorum and linguarum was made. Cheek, tongue, and lip biting occurs with some regularity and often patients are unaware of this habit. The diagnosis of morsicatio is based on clinical appearance and additional diagnostics are unnecessary. The condition belongs to a subcategory of obsessive-compulsive disorders. Treatment is not always necessary, but may consist of making the patient aware of the cause, possibly combined with symptomatic and/or causal therapy, for instance with an occlusal splint or cognitive behavioral therapy.

High SMAS Facelift: Combined Single Flap Lifting of the Midface, Cheek, and Jawline.

The traditional deep plane and "low" cheek superficial musculoaponeurotic system (SMAS) flaps elevated below the zygomatic arch suffer the drawback that they cannot, by design, exert an effect on tissues of the midface and infra-orbital region. Traditional deep plane and low designs target the lower cheek and jowl only and produce no improvement in the upper anterior cheek and "midface" area. Planning the flap "higher," along the zygomatic arch, and extending the dissection medially in an "extended SMAS" fashion to release and mobilize midface tissue, overcomes this problem and allows a combined, simultaneous, single flap lifting of the jawline, cheek, and midface. An improved outcome is obtained in many patients and no separate midface lift procedure is needed.

Subperiosteal Midface Lift with Sub-Superficial Musculoaponeuritic System Rhytidectomy.

The subperiosteal midface lift is a powerful tool that allows the surgeon to reposition the SOOF and malar fat pad in a vertical direction. Additionally, it significantly softens deep nasolabial folds. Its effect, however, is minimal with regards to addressing the jowl, jawline, gonial angle and cervicomental angle. Combining the subperiosteal midface lift with an extended sub-SMAS rhytidectomy addresses the pre-jowl sulcus by releasing the mandibular ligament. The jawline and gonial angle become more defined with the transposition and suspension of the SMAS flap. The SMAS transposition flap along with the suspension of the platysma flap to the mastoid fascia support the submandibular glands and deepen the cervicomental angle. These two approaches are valuable additions to the surgeons armamentarium and can yield excellent results in carefully selected patients.

An intriguing new diapsid reptile with evidence of mandibulo-dental pathology from the early Permian of Oklahoma revealed by neutron tomography.

The initial stages of diapsid evolution, the clade that includes extant reptiles and the majority of extinct reptilian taxa, is surprisingly poorly known. Notwithstanding the hypothesis that varanopids are diapsids rather than synapsids, there are only four araeoscelidians and one neodiapsid present in the late Carboniferous and early Permian. Here we describe the fragmentary remains of a very unusual new amniote from the famous cave deposits near Richards Spur, Oklahoma, that we recognize as a diapsid reptile, readily distinguishable from all other early amniotes by the unique dentition and lower jaw anatomy. The teeth have an unusual reeding pattern on the crown (long parallel ridges with rounded surfaces), with some teeth posteriorly tilted and strongly recurved, while a ventral protuberance forms the anterior terminus of the dentary. Overall, the lower jaw is unusually slender with a flattened ventral surface formed by the dentary and splenial anteriorly and the angular in the mid-region. The presence of a very slender triradiate jugal revealed through computed tomography confirms the existence of a large lower temporal fenestra, while the medial edge of the maxilla and the anatomy of the palatine confirm the presence of a large suborbital fenestra. Computed tomography of this new taxon reveals maxillary innervation that is characteristically reptile, not synapsid. Although no other definitively identifiable skull roof elements exist, the suborbital fenestra borders preserved on the palatine and maxilla supports the hypothesis that this is a diapsid reptile. Interestingly, the right dentary shows evidence of pathology, a rarely reported occurrence in Paleozoic amniotes, with several empty tooth sockets filled by bone. This small predator with delicate subthecodont implanted dentition provides strong evidence that diapsid reptiles were already diversifying rapidly in the early Permian, but likely were relatively rare members of terrestrial vertebrate assemblages.