Concentration of Hyaluronic Acid in Human Vocal Folds in Young and Old Subjects

Korn, Gustavo Polacow; Martins, João Roberto Maciel; Park, Sung Woo; Mendes, Aline; Kobayashi, Elsa Yoko; Nader, Helena B.; Biase, Noemi Grigoletto De

doi:10.1177/0194599811419457

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…Other than striated muscles, elastic fiber-mediated connections have been described in the larynx [30,31], the middle ear [32] and the urethra [9] (Figure 1…”

Section: Levator Ani Muscle Collagenous Fibers and Elastic Fibersmentioning

confidence: 99%

Supportive tissues of the vagina with special reference to a fibrous skeleton in the perineum: A review

Sasaki¹,

Hinata²,

Kurokawa³

et al. 2014

OJOG

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With the aid of immunohistochemistry, the present review attempts to demonstrate the composite fibers and nerve topographical anatomy in the vaginal supportive tissues. Along the tendinous arch of the pelvic fasciae, distal parts of the pelvic plexus extend antero-inferiorly and issue nerves to the internal anal sphincter as well as the cavernous tissues. At the attachment of the levator ani muscle to the rectum, smooth muscles in the endopelvic fascia lining the levator ani merge with the longitudinal smooth muscle layer of the rectum to provide the conjoint longitudinal muscle coat or the longitudinal anal muscle (LAM: smooth muscle). However, at the rectovaginal interface, the longitudinal smooth muscle layer of the rectum continues to the LAM without any contribution of the endopelvic fascia. The bilateral masses of the perineal smooth muscles (PSMs) are connected by the perineal body, and the PSMs receive 1) the longitudinal anal muscle, 2) the internal and external anal sphincters and, 3) the perineal membrane lining the vestibular wall. Tensile stress from the levator ani seems to be transferred to the PSMs via the LAM. Because of their irregularly arrayed muscle fibers, instead of a synchronized contraction in response to nerve impulses, the PSMs are likely to act as a barrier, septum or protector against mechanical stress because, even without innervation, such smooth muscle fibers resist (not absorb) pressure, in accordance with Bayliss' rule. The external anal sphincter, a strong striated muscle, inserts into the PSMs and seems to play a dynamic role in supporting the rectovaginal interface to maintain the antero-posterior length of the urogenital hiatus. However, we do not think that smooth muscles play an active traction role without cooperation from striated muscle. The fibrous skeleton composed of smooth muscle in the female perineum is explained in terms of a "catamaran" model.

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“…Other than striated muscles, elastic fiber-mediated connections have been described in the larynx [30,31], the middle ear [32] and the urethra [9] (Figure 1…”

Section: Levator Ani Muscle Collagenous Fibers and Elastic Fibersmentioning

confidence: 99%

Supportive tissues of the vagina with special reference to a fibrous skeleton in the perineum: A review

Sasaki¹,

Hinata²,

Kurokawa³

et al. 2014

OJOG

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“…Lebl et al, 14 using a more reliable histochemical technique, revealed a clear distinction between layers with more pronounced HA staining in the intermediate and deep lamina propria in comparison with the superficial layer. Finally, Korn et al 20 found a higher HA concentration in the cover (superficial lamina propria) among women compared with men.…”

Section: Discussionmentioning

confidence: 95%

Hyaluronan in Human Vocal Folds in Smokers and Nonsmokers—A Histochemical Study

et al. 2016

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Summary Objectives/hypothesisTo study the hyaluronan occurrence in human vocal folds, with special regards to gender and smoking and to discuss the implications of findings. Study DesignThis is a descriptive/morphologic study. MethodsSixteen cadaveric vocal folds from eight individuals between 58 and 90 years old (six women and two men) were removed and studied morphologically. Three of the individuals had been cigarette smokers.A direct method for hyaluronan histochemistry using a hyaluronan-binding protein probe (HABP) was used to visualize the polysaccharide. Five examiners performed an analysis of the intensities of hyaluronan staining, independently. ResultsWe observed intense hyaluronan staining of the vocal folds of which those from women stained considerably stronger than those from men. Stratified squamous epithelium stained for hyaluronan in all sections, whereas respiratory epithelium only stained weakly or not at all. The highest accumulation of hyaluronan occurred subepithelially in the lamina propria, corresponding to Reinke's space. It was observed that vocal folds from smokers were more intensively stained than those from nonsmokers. 2 ConclusionsHyaluronan is found in all layers of the human vocal fold. Contradictory to earlier studies, hyaluronan was visualized in squamous epithelium, where it may function as an impact protector. The occurrence of hyaluronan in smokers may have implications in the development of vocal fold inflammation and tumor initiation as hyaluronan is an important molecule in these processes.

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“…Elastic fiber-rich connective tissues have been well described in the larynx [16] [17], the middle ear [18] and the urethra [19]. According to Hinata et al [19], the male urethra contains a much greater amount of elastic fibers than the female urethra.…”

Section: Discussionmentioning

confidence: 99%

The Perineal Membrane: Its Composite Fibers and Nerve Content, and Relationship to the Levator Ani and Deep Transverse Perineal Muscles

Kurokawa¹,

Hinata²,

Sasaki³

et al. 2014

OJOG

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The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. To provide a better understanding of the topographical relationship between the PM and the levator ani muscle, we examined histological sections from 15 female cadavers. The composite fibers of the PM were usually continuous with that of a fascia covering the inferior or lateral surface of the levator ani (fascia diaphragmatis pelvis inferior) rather than the endopelvic fascia covering the superior or medial surface of the latter muscle. However, this fascial connection was sometimes interrupted by a venous plexus. The deep transverse perineal muscle was consistently adjacent to the posterolateral aspect of the PM, but whether it extended superficially or deeply to the PM depended on size of the muscle. In contrast to the endopelvic fascia embedding abundant middle-sized nerves (cavernous and sphincter nerves; 0.05-0.1 mm in thickness), the PM contained very thin nerves: many in 10 cadavers but few in 5 cadavers. Most of the nerves seemed to be sensory on the basis of immunohistochemistry. The levator ani muscle was considered likely to provide traction force to the PM, but active elevation appeared to be difficult because of the highly elastic nature of the PM and the interrupting venous plexus. Loss of nerves in the PM might be one of a number of factors that can accelerate pelvic organ prolapse.

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Concentration of Hyaluronic Acid in Human Vocal Folds in Young and Old Subjects

Cited by 15 publications

References 19 publications

Supportive tissues of the vagina with special reference to a fibrous skeleton in the perineum: A review

Supportive tissues of the vagina with special reference to a fibrous skeleton in the perineum: A review

Hyaluronan in Human Vocal Folds in Smokers and Nonsmokers—A Histochemical Study

The Perineal Membrane: Its Composite Fibers and Nerve Content, and Relationship to the Levator Ani and Deep Transverse Perineal Muscles

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