Surgery Research Image Contest Winners

With active clinical and basic science research programs, there’s always something cool under the scope in our Department. Check out the winners of our annual Surgery Research Image Contest to get a glimpse into some of the research we’re working on.

First place – Intrinsic Tongue Tissue Section of Young Ts65Dn Mouse Model of Down Syndrome

Taken by Tiffany J. Glass, Research Associate, Dr. Nadine Connor’s lab

This is an image of a tissue section from the intrinsic tongue of a young (3 week old) Ts65Dn mouse model of Down syndrome. Muscle fibers are outlined in green (anti-Laminin, AF488). Fast muscle fibers are stained in blue (anti-MyHC 2b, AF350). Relatively slower muscle fibers are stained in red (anti-MyHC 2a, AF568). This image shows a preponderance of fast muscle fibers near the front of the tongue, and slower muscle fibers near the back of the tongue. This image was taken on an epifluorescence microscope at 10X magnification. The images in this experiment might be the first in the world to visualize the four major intrinsic tongue muscles (superior longitudinal, inferior longitudinal, transverse, and verticalis) in Down syndrome. Down syndrome is associated with impairments of breathing, speaking, and swallowing. These impairments may involve developmental differences of the tongue.

Runner-up – Human Dermal Fibroblasts Growing on a Mineralized Parsley Stem

Taken by Gianluca Fontana, Research Associate from Bill Murphy’s lab, collaborating with Dr. Hau Le

In this image, human dermal fibroblasts are growing on a mineralized parsley stem. A parsley stem was decellularized and consequently mineralized to enable the adhesion of human cells. The image was captured using a scanning electron microscope and it was pseudo-colored to facilitate its interpretation. Plant tissues can be decellularized and functionalized to enable adhesion and expansion of human cells. Thus, plants can be used as an alternative feedstock of perfusable biomaterials. To date there is a lack of biomaterials with adequate fluid transport capabilities, limiting the number of cells that can be implanted with the biomaterial. We have shown that decellularized plant tissues are biocompatible and can support the metabolic activity of high number of cells for extended periods of time.

Runner-up – Blood Vessels in the Inner Cheek of a Dog

Taken by Noah Borchardt, Medical Student Assistant Researcher, Dr. Jack Jiang’s Laryngeal Physiology lab

A plastic gel was pushed through the large vessels in the upper respiratory tract of a donated dog specimen. The gel made its way through the vascular network where it solidified. The tissue was then corroded away leaving a cast of the blood vessels. Scanning electron microscopy was used to visualize the microscopic details of the cast and to obtain this image. The large vessels with grooves on the surface are arteries and the large smooth vessels are veins. The smaller vessels are capillaries with the smallest ones shown being 6 microns across, about the diameter of a single red blood cell. This image was taken as part of a study to describe the microvascular architecture of different mucosal membranes.

Other Great Submissions

Medical Illustration Demonstrating Cleft Palate Repair On Dogs

Drawn by Dr. Ruston Sanchez, Plastic Surgery Resident

There is a paucity of veterinary literature devoted to cleft lip repair techniques in the dog. He compiled an article reviewing pertinent embryology, classification, etiology, epidemiology, comparative anatomy and management of the canine cleft lip. With his team, he then presented a novel adaptation of the Millard rotation-advancement closure, a popular technique used for human cleft lip repair, to that of a female pit bull terrier cross with a wide left unilateral complete cleft lip. In adaptation to the canine, technical refinements were made based on differences in anatomical structure and physiologic endpoint. This step-by-step figure illustrates this adaptation and is an original composition by Dr. Sanchez.

The rejected nephron

Taken by Juan S. Danobeitia, General Surgery Resident and Post-doctoral Scientist, Dr. Luis Fernandez‘s lab

This image depicts a renal glomerulus within the cortex of a transplanted kidney and undergoing rejection by the immune system. The area in green represents deposition of C3b, a breakdown product of complement activation. The area in orange represents formation of the membrane attack complex (MAC), the terminal product of complement activation. When found together at the level of the nephron in a graft that is rejecting clinically, they confirm the important role of the complement system in the mechanisms that regulate immunological rejection. This technique demonstrates pathophysiology of the immune response during tissue rejection and allows investigators to test the effect of novel targeted therapies aimed at treatment and prevention of tissue rejection.

3D Printed Heart Model

Taken by Dr. Joshua Hermsen, Cardiac Surgeon

The picture shows a 3D printed heart that was used to prepare for surgery on a patient with hypertrophic cardiomyopathy.  The surgery, called ‘septal myectomy,’ was performed on the print in the simulation lab the day before being performed on the patient. The red circle highlights the area of model that was resected. To the right of the model are the model and patient resection specimens which were very similar in size. This operation, in which a piece of overgrown muscle is simply resected, is one of the few heart operations that can be reasonably simulated with current 3D printing technology. The ability to pre-operatively simulate a patient-specific intra-cardiac operation is new and exciting. If practice makes perfect, this kind of surgical ‘rehearsal’ may be a paradigm to improve the quality of this operation.

Learn more about the Cardiothoracic Surgery Division

Pig Vocal Folds

Taken by Renee King, Pre-doctoral trainee, Dr. Susan Thibeault‘s lab

This image depicts pig vocal folds using proton-density weighted magnetic resonance imaging, which is highly sensitive to water. Here, empty space is dark, water and fat are bright, and muscle and cartilage are varying shades of gray. The vocal folds form an upside-down V in the middle of the image, and the bright line just inside their edges represents a high concentration of water in the mucosal layers close to the surface of the tissue, on top of the muscle. Vocal fold mucosa and muscle affect voice quality and function in different ways. The ability to measure water within distinct vocal fold tissue layers could help researchers study how hydration changes the voice.

Learn more about the voice research training program.

Cross-section of Thyroarytenoid (TA) Muscle from Rat Larynx

Taken by Jacob M. Lake, Research Specialist, Dr. Michelle Ciucci‘s lab

This 10µm cross-section of thyroarytenoid (TA) muscle was taken from the larynx (voice box) of a rat, stained to visualize its component muscle fibers, then imaged under 40x magnification using a fluorescent microscope. At this depth, the thyroid cartilage (red, left) and portions of the vocal folds (blue, upper right) surround both divisions of TA muscle fibers (green, central sections). The Ciucci lab studies the onset and progression of Parkinson disease. They believe there may be signs of disease in both the body and the brain, specifically in the nerves and muscles controlling swallowing and vocalization. One function of the TA muscle is to modulate vocalization by adjusting the shape of the larynx. They’re investigating whether  there are signs of early pathology in this region that could lead to the communication and swallowing deficits seen in later-stage Parkinson disease.

Mom Dresses Her Daughter’s Cells

Taken by Diego A. Lema, Research Assistant, Dr. William Burlingham’s lab

The strip shows a series of markers in a fetal white blood cell from the umbilical cord. This fetal cell shows a protein not present in the mother (Jok3H5 in green), identifying it as coming from the daughter, but it also shows bits of A2 in its surface (red), a maternal protein she did not inherit. How is it possible for this baby’s cells to have a non-inherited gene’s protein? In mouse models, it’s been discovered that this is because mother’s cells are transferred to the offspring during pregnancy, survive until adulthood and release vesicles that “dress” the offspring’s own cells. This image could be the first time this is observed in humans. This cell also has PD-L1 in the same spots, a suppressor of the immune system: The mom is educating the daughter’s immune system to not attack her.

Recanalization of murine embryonic vocal folds

Taken by Vlasta Lungova, Dr. Susan Thibeault‘s lab, under grant number NIH NIDCD R01 AAA 6935

The image represents double immunofluorescent staining for anti-cytokeratin 8 (green) and anti-SOX2 (red) in vocal fold (VF) epithelial progenitors in a mouse embryonic larynx. During recanalization of the laryngotracheal tube vocal fold epithelial progenitors initiate stratification and differentiate into two rows of SOX2+ expressing cells. Simultaneously, the basal layer of SOX2+ cells downregulates K8 expression. Specification of basally positioned vocal fold epithelial progenitors is necessary for their terminal conversion into functional basal cells giving rise to a suprabasal layer that disintegrates during VF separation. Failure in VF separation leads to congenital laryngeal disorders, such as laryngeal webs or stenosis.

Topography of a lesion from the human vocal fold

Taken by Sarah Rosen, Post-doctoral trainee, Dr. Susan Thibeault and Dr. Tim McCulloch labs

This lesion, which most often causes hoarseness of the voice, was surgically-removed and imaged using Scanning Electron Microscopy. Images illustrating the three-dimensional structure of the lesion surface can help improve understanding of the recurrent nature of this pathology and may help to better direct clinical treatments in the future.

Learn more about the voice research training program.


Thyroidectomy (partial or total) rates per 100,000 Medicare beneficiaries by hospital referral region

Prepared by Dr. David O. Francis, Division of Otolaryngology

This image demonstrates the wide variability in thyroidectomy rates across the country. Rates do not align with health care availability, regional socioeconomic status, or surgeons per capita, suggesting variation is owing to causes other than disease burden. Wide variation in thyroidectomy rates observed among Medicare beneficiaries suggests widely divergent local beliefs and practice patterns surrounding the management of thyroid cancer. Variation research provides vital insight into disparities in care and the degree of consensus on how to manage a particular condition.

the heart of microsurgery, an ode to the suture

Taken by Nikita Shulzhenko, Medical Student and Research Fellow, Dr. Samuel O. Poore’s lab

There is perhaps no object more synonymous with surgery than the suture. From blades of grass, to catgut, to polymers and beyond, humanity has been progressively given the power to restore that which has been torn apart. In the past 50 years, alongside the development and refinement of microsurgery, we have seen suture sizes shrink to astounding sizes—11-0 at only a mere 10 microns in diameter. These microscopic materials have given us the ability to deliberately approximate increasingly finer vessels and nerves not only in the clinic but the laboratory as well. This image of an 8-0 nylon suture tied into a heart-shaped knot (20x magnification) offers homage to this invaluable tool without which work in neural regeneration and repair, neural electrode interfacing, and microsurgical research and training would be impossible.

Produced by Nick Zaborek, Assistant Researcher, Dr. David Schneider, WiSOR

This image visualizes two dosing algorithms used to prescribe Levothyroxine (thyroid replacement hormone) in patients after thyroidectomy. On the Y-axis is patient’s ideal dosage, plotted against patient weight on the X-axis. Importantly, the visualization shows how the standard dosing method (green line) fails to distinguish between males and females, despite their different needs. The orange and blue lines visualize predictions from our Poisson dosing algorithm for males and females, respectively. The image was generated with R (version 3.4.2), a statistical software language.