A new factor involved during childbirth labor: the importance of having a good dental occlusion.

It is widely recognized that the physiology of childbirth labor largely depends on the interaction between three factors: a) the force generated by uterine contractions; b) the structure and characteristics of the birth canal and c) the fetus. Harmony between these three variables determines the initiation of maternal dynamic phenomena and the establishment of an optimal maternal-fetal balance in which both warrant for a correct delivery timing. The present study considered the above known factors and assessed if any other factor, still not recognized, could also play a role, and eventually modify the timing of delivery during the expulsive period. In particular, we focused our attention on the role played by the temporomandibular joint and dental occlusion on maternal body balance and on the stability of muscular reflected forces. The importance of assessing the temporomandibular function and the dental occlusion lies in the fact that any alteration in chewing or in temporomandibular joint (TMJ) mobility and occlusion brings to relevant modifications on the vertebral column and pelvic girdle. Our hypothesis is based on the evidence that those women who have any kind of alteration in their dental occlusion, can have an altered capability of pushing during the expulsive period, as the force applied on the pelvic floor is not expressed. Moreover, recent studies have highlighted a relationship between temporomandibular dysfunctions and sleep apnea syndrome and between sleep apnea syndromes and pregnancy. These relationships are explored in this study.

Does a short lingual frenulum affect body posture? Assessment of posture in the sagittal plane before and after laser frenulotomy: a pilot study.

The factors that characterize posture are neurophysiological, biomechanical, psychoemotional. Neurophysiological factors concern the modulation of tone, muscle tone is the result of a series of neuropsychological processes within the tonic-postural system. The tonic-postural system can become unbalanced for various reasons, including a tight lingual frenum. The aim of this pilot study was to evaluate the benefits of frenulectomy by laser on body posture and on the scapular (shoulders) anteroposterior movement. Twenty-four healthy subjects were selected, between the ages of 10 and 26 years (mean age 15.22) who presented a short lingual frenum and a low posture of the tongue and jaw. They were examined using the Marchesan Protocol for Lingual Frenum and the Spinometry® Formetric and underwent laser frenectomy by diode laser (Siro Laser Blu. 660 nm) without any post-surgery complications. The release of the frenulum immediately brought benefits to patients, reorganizing the physiological modulation, and the movement of the tongue within the normal parameters of temporomandibular kinematics which were within physiological parameters. Frenectomy improved the anterior-posterior flexion of the scapulas (shoulders) in the sagittal plane but a larger sample is required to have statistically significant results.

Low cadmium concentration in whole blood from residents of northern Sardinia (Italy) with special reference to smoking habits.

INTRODUCTION: The present study was initiated to investigate the cadmium concentrations in whole blood of Northern Sardinian, non-occupationally exposed adult subjects. Sardinia is a large Italian island which differs genetically and environmentally from other mainland Italian areas. METHODS: Two hundred and forty-three adults (157 females and 86 males) were selected in the study area from subjects who were undergoing blood collection for laboratory analysis during the period January 2005-May 2005. Whole blood was analysed by graphite furnace atomic absorption spectrometer equipped with a Zeeman-effect background corrector (Perkin Elmer ZLS5100) and an auto sampler. The adopted analytical procedure uses the Stabilized Platform Temperature Furnace (STPF) technique. RESULTS: The mean value of Blood Cadmium Concentration (BCdC), expressed as Geometric Mean, was 0.32 pg/l (CI 95%: 0.31-0.34 l) in non-smokers to 034 pg/l (CI 95%: 0.30-0.39 pg/l) in ex-smokers up to 0.47 gg/ll(CI 95%: 0.42-0.53 pg/l) in smokers (p < 0.0001). DISCUSSION: The results show that BCdC levels in Northern Sardinian non-occupationally exposed adults are lower than levels found in many other regions, including those within Italy. Nevertheless, similar values have been detected in other European countries and cities. CONCLUSIONS: In relation to other reports in which data were analysed by strata for smoking habit and age, we found similar BCdC values among non smokers. However, Sardinian smokers seem to show lower levels of blood cadmium.

Syncytial units isolated from early human placentas.

This morphological study demonstrates that during the early phases of pregnancy, in the syncytium there are individual multinucleated units joined to one another by junctional complexes which probably are destined to flow together with the main syncytium by membrane breakdown. Normal human placentas from 6th to 12th week of pregnancy, derived from voluntary abortions, have been utilized. According to the method described by Tedde et al. (1991), clusters of villi have been isolated, washed in saline and subjected to a treatment with a 0.3% trypsin solution that caused the detachment of numerous cellular elements from the surface of the free villi. Such isolated elements have been subjected to centrifugation and separation in Percoll gradients. Then multinucleated syncytial units have been collected, attached to slides by cytocentrifugation, stained with toluidine blue, observed at the light microscope and utilized to count their nuclei: about 600 elements from different weeks of pregnancy have been considered and the results have been submitted to statistical analysis. The svncytial units are multinucleated and can often be different from one another, particularly in regard to the characteristics and the number of the nuclei. The evaluation of the number of nuclei contained in different syncytial elements shows that nuclei are less numerous in the early phases (6-8 weeks) and increase in number towards the end of the first trimester in a statistic significant way. In conclusion, the present study could confirm the existence of single syncytial units, joined to constitute the syncytial layer, probably destined to a complete fusion in the main syncytium and likely in functional relationship with the underlying Langhans cells.

The trabecular structure of developing human mandible.

In this paper we tried to analyse in quantitative terms the differences in trabecular structure of human mandibles 8, 10 and 12 weeks old. The analysis was performed on decalcified Sirius-red stained trabeculae, photographed in polarised light. The data obtained from Fourier transforms of scanned pictures were evaluated by discriminant analysis to show the differences between the analysed stages of development. Also, various parts of the mandible were compared because the clinical experience shows that the frequency of pathological changes is different in different parts of mandible bone. The complexity of trabecular structure of bone samples was measured by fractal dimension. It is concluded that this quantitative approach is reliable and, in the future, could be used for physiological and pathological analyses of bone biopsies.

Localization of collagen type IV, fibronectin and elastin in the flexor digitorum tendons and in the perichondrium during prenatal development of the human hand.

The distribution of collagen type IV, fibronectin and elastin in the flexor digitorum tendons and in the perichondrium of staged human embryos and fetal hand (from 6 to 12 weeks of gestation) has been studied to analyse the immunohistochemical features of the human hand during the first trimester of pregnancy. At 6 weeks in the transverse sections of the fingers there is no evidence of the presence of collagen type IV and elastin which remain absent even in the controls of 9, 11 and 12 weeks. On the contrary from 6 weeks of intrauterine life the fibronectin is widely distributed with thickening above all in the perichondrium and in the subjacent portion of the cartilaginous model of the bone. At 9 weeks a high positivity is detected not only along the perichondrium but even into the extra-cellular matrix of every mesenchymal cell. At 11 and 12 weeks the perichondrium is always positive but a high positivity is now present along the flexor tendons and their related sheaths that show a high grade of differentiation. To sum up, the absence of the collagen type IV into the flexor and extensor tendons is understandable because it isn't a fibrillar collagen. More difficult is to understand the absence of the elastin (component of the mature tendons) until the 12th week. On the contrary the presence of the fibronectin, a structural glycoprotein, proof of active morphogenesis of mesenchvmal cells, earlier in the perichondrium and cartilaginous sketch and later in the flexor tendons and their sheaths indicates that probably among the cells of mesenchymal origin the perichondrium with the cartilaginous model of the bone come before and perhaps orient the differentiation of the other components of the human hand.

Histogenesis and morphology of the flexor tendon pulley system in the human embryonic hand.

The number, position, structural and ultrastructural features of the flexor tendon pulley system in six human embryonic hands, aged from 6 to 12 weeks, were studied by light and electron microscope. The pulley system can be recognized from the ninth week; later, at 12 weeks, the structures are easily identified around the flexor tendon in positions closely correlated to those found during post-natal growth and in the adult hand. Structurally and ultrastructurally the pulleys are not simply thickened portions of the sheath. They are formed by three layers: an inner layer, one or two cells thick, probably representing a parietal synovial tendon sheath; a middle layer formed by collagen bundles and fibroblasts whose direction is mainly perpendicular to the underlying phalanx; and an outermost layer consisting of mesenchymal tissue with numerous vessels which extends dorsally in an identical layer, forming a ring that includes flexor and extensor tendons and the cartilaginous model of the phalanx. The pulley does not have a semicircular shape but a much more complicated one, owing to the middle layer which in part runs dorsally and in part ventrally, under the flexor tendons.

Morphometric analysis of the lateral ventricles in living human.

The evaluation of the volume of the encephalic ventricles in the living human has a great importance in diagnosis and monitoring of several pathologies. As well as a good measuring accuracy, a great usefulness has the facility of execution. The present study would be a contribution to the search of systems of analysis that assure both fast execution and greatest precision of the quantitative values. Brain MRI scans from 10 female individuals, aged from 25 to 60, with no apparent neurologic or psychiatric pathology have been studied. The brains were evaluated with 5 mm slices thickness (gap 1 mm) scans performed in axial and coronal planes and obtained by means of long and short spin echo sequences. Images have been acquired on a Personal Computer and submitted to a semiautomatic morphometric analysis. The values obtained are in accordance with the range of normal values reported from the literature, showing also a lower standard deviation; besides this clear accuracy of measurement, it's important to emphasize the facility and swiftness in the execution of the imagine evaluation.

[Activation of the immune system in periapical infection. 1. Lympho-monocytoid and plasma cellular elements of reactive soft tissue cells]. / Attivazione del sistema immunocompetente nella patologia del periapice infetto. Nota 1: elementi cellulari della serie linfomonocitoide, plasmacellulare e propri dei tessuti molli reattivi.

The authors have carried out a study on the immunitary mechanisms which stimulate and avoid eventual alterations of infected periapex. Above all the aim of this first study has been the microscopic and ultrastructural valuation of the cellular components that characterize the process of chronic phlogosis of periradicular tissue, lymphocytes T and B, plasmacells and macrophages, and of those even more typical of the soft reactive tissues, fibroblasts and epithelial cells. It's just the interaction among these immunocompetent cells which determines the structural change of the periapical bone whose most common image of radiotransparence make it possible to diagnose the sufference of the pulpo-periapical system.

Blood and/or lymphatic connection of laryngo-pharynx and thyroid: an anatomic and clinical problem.

Three patients, undergoing surgery for pharyngeal carcinoma, were studied after their informed consence in the aim of ascertaining: 1) whether the routinary hemithyroidectomy in case of surgical treatment of the cancer of pyriform sinus is justified by a real probability of neoplastic invasion of the gland, and 2) which pathway the neoplasia follows in the metastatic process. In each patient a small amount of methylene blue solution was injected in the pyriform sinus submucosa, just before starting the surgical operation, currently including hemithyroidectomy. The stain spreads to the superior portion of the thyroid lobe, and seems to follow the periarterial lymphatic vessels. Even if further researches are necessary, the obtained data seem to justify routinary thyroidectomy in course of surgical treatment of the hypopharyngeal cancer.

Presence of antisperm antibodies in the serum of Sardinian adult people. II. Study on a selected infertile population in north Sardinia.

Among many possible causes of infertility an immunological factor must be considered, in particular the presence of antibodies to spermatozoa in the serum. In previous researches we confirmed the presence of antisperm antibodies in the serum of healthy men of North Sardinia in percentage equal to 2.4% of the considered population. The aim of the present study is to evaluate the correlation between the presence of antisperm antibodies and infertility. The presence of antispermatozoal antibodies has been evaluated in the serum of 124 men (aged 25-50) affected by unexplained infertility utilizing the indirect immunofluorescence and ELISA methods. The presence of antisperm antibodies has been found equal to 19.3% of the tested sera. These results show that the incidence of antisperm antibodies is higher in the serum of male partners from infertile couples than in healthy subjects (P < 0.01), also in a relatively segregated and pure population like the one studied.

[Morphological characteristics of mastocytes in the infertile human testicle]. / Caratteristiche morfologiche dei mastociti nel testicolo umano infertile.

Mast cells, basophilic elements of the connective tissue, have been studied in numerous researches carried out both in man and animals. Previous studies showed that mast cells have been found in increased number in testis affected by pathology. In the present research morphologic characteristics of the mast cells in human infertile testis have been studied. Testicular biopsies obtained from 49 subjects, aged from 21 to 61 years, have been treated according to the current techniques for transmission electron microscopy. Results showed that it is possible to distinguish at least two types of mast cells: 1) "Interstitial" mast cells, large, round shaped, with great content of large characteristic granules, in relation with the loose connective tissue surrounding capillary vessels and Leydig cells; 2) "Peritubular" mast cells, flattened and relatively poor in granules, trapped in the conspicuous peritubular collagenic layers. These two types of mast cells differ from one another as concerns not only localization, but also general morphological characteristics and number and ultrastructure of cytoplasmic granules. Probably it is possible to establish a relationship between peritubular mast cells trapping and the increased deposition of fibrous connective tissue in the peritubular layers; such a deposition characterizes a lot of testicular pathologies.

Mechanisms of regulation of the capillary bed in the human chorionic villi.

The purpose of the present researches was to confirm the hypothesis that in the human placenta the microcirculation is subjected to humoral control, because of the absence of innervation in the chorionic villi and the ability of the capillaries to contract themselves. Chorionic villi were incubated in presence of vasoactive substances, Histamine, Serotonin, Bradykinin, Dopamine, Enkephalin Prostaglandins. After incubation, the specimens were fixed and embedded in resin. Semithin sections were submitted to a computerized analysis for the evaluation of the ratio between surface of capillaries and surface of the villus. The results confirmed that in the control of capillaries in the human placenta most of the tested substances show a specific action, dose- or time-dependent.

Presence of antisperm antibodies in the serum of Sardinian adult people. I. Study on healthy adult men in north Sardinia.

Infertility is a problem estimated to occur in 15-20% of couples. Among many possible causes of this condition, an immunological factor must be considered, in particular the presence of antibodies to spermatozoa in the serum and also in the seminal plasma. Several researches agree in reporting that the incidence of such antibodies is considerably higher in men affected by impairment of spermatogenesis than in healthy subjects as showed also in our Institute. In order to widen our knowledge of the topic at issue, considering that there are no data concerning this problem in Sardinia, we thought it right to begin an epidemiological research about the incidence of antispermatozoal antibodies in the resident, adult and seemingly healthy male population. Therefore, we have tested the serum of 250 men, aged from 20 to 50, habitual blood donors registered in Transfusional Centres of North Sardinia, who have never manifested failures of the reproductive system; for the detection of the antispermatozoal antibodies, we have adopted the indirect immunofluorescence assay. The first results show that, in a few cases, corresponding to 2.4 per cent, also in a highly selected population antibodies to spermatozoa were present, and they were directed particularly against the acrosome and the equatorial segment. The ultimate aim of the research is to give epidemiological data, concerning both sexes, that may be utilized in a wider study of the local causes of infertility.

[Morphological findings in cryptorchism in the adult male]. / Rilievi morfologici sul criptorchidismo nell'uomo adulto.

Cryptorchidism, the most common endocrine disturbance in the newborn, is still present in 0.3% of all postpubertal men as monolateral or bilateral condition. The undescended testis, in postpubertal age, is permanently damaged, so about 80% of cryptorchids are subfertile or definitively sterile. In the present study we relate our observations on structure and ultrastructure of testicular biopsies obtained from 29 cryptorchid men aged from 16 to 64. The individual pattern of morphological alterations is closely related to age and position of undescended testis. The following aspects are recognizable in cryptorchid testis: 1) seminiferous tubules reduced in size and irregular in shape; 2) tubular lumen occluded; 3) reduced germ cell population; 4) altered stages of spermatogenesis; 5) increased thickness of spermatogonia layer; 6) vacuolization of germ cells; 7) polynucleated germ cells; 8) acrosomal deformities; 9) delivery of immature germ cells; 10) Sertolisation of the seminiferous tubule; 11) immature Sertoli cells; 12) multilayered and thickened basement lamina; 13) peritubular fibrosis; 14) vascular fibrosis; 15) vacuolisation of Leydig cells; 16) interstitial mastocytosis. The findings present a mosaic of the morphological events, that are characteristic not only of the undescended testis but also of numerous testicular pathologies as well as of other conditions as prolonged hyperthermia, experimental ischaemia and senescence.

[Development of human fetal skin from the beginning of pregnancy to the 6th month. Light microscopy study]. / L'évolution de la peau humaine foetale dès le début de la grossesse jusqu'au 6e mois. Etude au microscope photonique.

The human foetal skin has been studied in 15 foetuses from the 8th to the 24th week of pregnancy, to analyse the most significative stages of its evolution. The skin of the ventral and dorsal regions of the hand and fingers has been studied. Just after excision, the hand buds have been fixed with neutral formaline, dehydrated, clarified and embedded in paraffin. The microtomic sections have been stained using different histological techniques. Different characteristics between the skin that will differentiate into thin and thick aspects have been observed already from the earliest stages of evolution. The differences occur especially at the level of the subepithelial mesenchyme, that conditions the development and the evolution of the two kinds of skin.