Enamel matrix derivative Emdogain as an adjuvant for a laterally-positioned flap in the treatment of gingival recession: an electron microscopic appraisal.

Enamel matrix derivative (EMD), such as Emdogain, has been suggested for the improvement of wound healing in periodontal surgical therapy. The present qualitative study seeks to illustrate the ultrastructural changes associated with a human gingival wound at 10 days after the application of EMD as an adjunct to a laterally-positioned flap in a patient with gingival recession. An otherwise healthy patient, who had been suffering from bilateral gingival recession defects on teeth #23 and #26, was studied. One defect was treated with a laterally-positioned flap, while the other was treated with a combination of EMD and a laterally-positioned flap. Ten days after the operation gingival biopsy specimens were obtained from the dentogingival region and examined using a transmission electron microscope. A considerable difference was found in both the cellular and extracellular phases of EMD and non-EMD sites. The fibroblasts of EMD site were more rounded with plump cytoplasms and euchromatic nuclei. A well-developed rough endoplasmic reticulum and numerous mitochondria could be detected. In contrast, the fibroblasts of non-EMD site were of flattened spindle-like morphology. While the signs of apoptosis could rarely be detected at EMD site, apoptotic bodies and ultra-structural evidence of apoptosis (crescent-like heterochromatic nuclei and dilated nuclear envelopes) were consistent features at non-EMD site. The extracellular matrix at EMD site mainly consisted of well-organised collagen fibres, while non-EMD site contained sparse and incompletely-formed collagen fibres. Coccoid bacteria were noted within the extracellular matrix and neutrophils at non-EMD site. It seems that EMD may enhance certain features of gingival wound healing, which may be attributable to its anti-apoptotic, anti-bacterial or anti-inflammatory properties.

Malignant fibrous histiocytoma of the spermatic cord: a case report and review of the literature.

Malignant fibrous histiocytoma (MFH) is a morphologically ill-defined tumour of the soft tissues and may involve nearly every organ of the body. MFH of the spermatic cord represents an extremely rare entity and reports of it in the literature are limited. We report a 69-year-old man found to have a left spermatic cord MFH and retroperitoneal and mediastinal lymphadenopathy, who was treated with radical orchiectomy and adjuvant chemotherapy. The morphological findings of the spermatic tumour are presented and the literature is reviewed to clarify the potential diagnostic/therapeutic approaches and the prognosis related to spermatic cord MFH.

The effects of an electromagnetic field on the boundary tissue of the seminiferous tubules of the rat: A light and transmission electron microscope study.

Human beings are unavoidably exposed to ambient electromagnetic fields (EMF) generated from various electrical devices and from power transmission lines. Controversy exists about the effects of EMF on various organs. One of the critical issues is that EMF may adversely affect the reproductive system. In order to examine this 30 rat pups were exposed to 50 Hz EMF (non-ionising radiation) during in utero development (approximately 3 weeks) and postnatal life (5 weeks). Groups of exposed rats were subsequently left in an environment free of EMF in order to observe recovery, if any, from the changes induced by EMF on the boundary tissue of the seminiferous tubules. The materials were processed and observed under a light and a transmission electron microscope. In the experimental rats boundary tissue was found disrupted at various layers. This tissue showed infoldings, which were perhaps due to the loss of collagen and reticular fibrils from the inner and outer non-cellular layers. The outer non-cellular layer, which was thinner than that of the control, was stripped away from the myoid cell layer in multiple regions, giving a "blister-like" appearance. The myoid cells showed fewer polyribosomes, pinocytotic vesicles and glycogen granules. Most mitochondria were found to lack cristae. The connections between individual myoid cells were apparently lost. There were signs of recovery in the boundary tissue following withdrawal from EMF exposure. These results suggest that EMF exposure may cause profound changes in the boundary tissue of the seminiferous tubules. Therefore exposure to EMF may result in pathological changes that lead to subfertility and infertility.

A rare variation of the vertebral artery.

Variations of the vertebrobasilar arterial complex are important with regard to their potential clinical impact. We present an unusual case of the vertebral artery, in which the left vertebral artery in its ascent in the neck through the transverse foramina passed posteriorly between the transverse processes of C3 and C4 and supplied the posterior muscles of the neck without continuing intracranially. Albeit speculatively, we hypothesise that the variation of the vertebral artery reported here was caused by degeneration of the proximal portion of the left postcostal longitudinal anastomosis (i.e. C1 and C2 intersegmental arteries) in the context of a persistent third cervical intersegmental artery. Our case is unique in that the left vertebral artery terminated extracranially. Knowledge of the variations of the vertebrobasilar arterial complex is important for surgeons operating at the skull base, craniocervical junction, and cervical region, and for clinicians interpreting the imaging of this region.

A rare variation of the inferior alveolar artery with potential clinical consequences.

Variations of the inferior alveolar artery are seemingly quite rare, especially with regard to its origin from the maxillary artery. We present an unusual case of an inferior alveolar artery that originated from the external carotid artery. To the best of our knowledge, our case is one of only two reports of the inferior alveolar artery arising from the external carotid artery. The clinician who deals with the mandibular region should be aware of such a variation in the arterial architecture.