Background: Extrafusal muscle fibers of human striated skeletal muscles are known to have a uniform innervation pattern. Motor endplates (MEP) of the ''en plaque'' type are located near the center of muscle fibers and distributed within the muscles in a narrow band. The aim of this study was to evaluate the innervation pattern of human facial muscles and compare it with that of skeletal muscles.Methods: Ten facial muscles from 11 human cadavers were dissected, the nerve entrance points located, and the dimensions measured. All muscles were stained in toto for MEPs using Acetylcholinesterase (AChE) and examined under the microscope to determine their location. Single muscle fibers were teased to evaluate the stained MEPs.Results: The length of the different facial muscles varied from 29 to 65 mm, which correlated to the length of the corresponding muscle fibers. MEP zones were found on the muscles in the immediate vicinity of the nerves' entrance points and located eccentrically. Numbers and locations varied from muscle to muscle. Three MEP zone distribution patterns were differentiated: numerous small MEP zones were evenly spread over the muscle, a predominant MEP zone and two to three small zones were spread at random, and two to four MEP zones of equal size were randomly scattered.One MEP of the ''en plaque'' type was found in 73.8% of the muscle fibers and two to five MEPs were found in 26.2%. The distances between the multiple MEPs on one muscle fiber varied from 10 to 500 µm.Conclusions: This study suggests that facial muscles differ from skeletal muscles regarding distribution and number of MEPs. The eccentric location of MEP zones and multiple MEPs suggests there is an independent mechanism of neural regulation in the facial muscle system. Anat.
In a macroscopical study the dimensions of the adult laryngeal skeleton of man and sheep were compared. In both species the data for male and female were evaluated separately. In contrast to pronounced differences in size between male and female human larynges, the dimensions of both sexes in sheep proved to be very similar. In respect of 7 size values, the sheep larynx falls in the range between the male and female human larynx. This applies to most values for height, the antero-posterior diameter and the inferior breadth of the thyroid cartilage. In the sheep cricoid, the height of the lamina and the inner transverse diameter correspond closely to the human counterpart. The most conspicuous differences vis-à-vis the human larynx are the narrowing of the upper portion, the absent upper incisure of the thyroid and the relatively large dimensions of the arytenoid cartilages in sheep. Since in sheep the dimensions at the level of the glottis and of the subglottic space are within the range of the human larynx, the suitability of the sheep larynx as a model for experimental clinical laryngology is discussed.
Results: A total of 104 examinations were performed. Mean age at first PET was 13.5 years (2.6-22.6). Eight patients had at least one malignant lesion; four of these patients were asymptomatic. Two of four symptomatic patients died, while all patients with asymptomatic malignant lesions are alive. All malignant tumours could be identified by PET imaging in both symptomatic and asymptomatic patients. All lesions judged as benign by [ 18 F]FDG imaging and clinical judgment were either histologically benign if removed or remained clinically silent during follow-up.SUVmax of malignant and benign lesions overlapped, but no malignant lesion showed FDG uptake ≤3.15. Asymptomatic malignant lesions were detected with a sensitivity of 100%, a negative predictive value of 100% and a specificity of 45.1%.
Conclusion:Malignant transformation of PN also occurs in asymptomatic children and adolescents. Detection of MPNST at early stages could increase the possibility of oncologically curative resections.
K E Y W O R D S[ 18 F]FDG-PET, children, malignant peripheral nerve sheath tumour, neurofibromatosis type 1, plexiform neurofibroma
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