Tumor necrosis factor in synovial fluids of temporomandibular joint dysfunction syndrome

With the MTT tetrazolium WEHI 164 clone 13 cell cytotoxicity assay, we measured TNF alpha (tumor necrosis factor) activity in synovial fluids of TMJDS (Temporomandibular joint dysfunction syndrome). We found no detected TNF alpha level from 5 patients with muscle dysfunction, raised TNF alpha levels from 5 of 11 patients with internal derangement and from 9 of 11 patients with organic destruction (osteoarthritis). The findings of biologically active TNF alpha in synovial fluids of TMJDS suggest that TNF alpha may play a role in the pathogenesis of TMJDS.     

Immunohistochemical distribution of lymph capillaries and blood capillaries in the synovial membrane in cases of internal derangement of the temporomandibular joint

The distribution of lymph capillaries and blood capillaries in the synovial membrane was examined immunohistologically with anti-human collagen IV antibody and anti-human von Willebrand factor in 26 human temporomandibular joint (TMJ) samples comprising discs with adjoining synovial membrane from 10 control TMJs and from 16 TMJs with internal derangement. Three different distribution types were observed in the synovial membrane. In the control samples, the occurrence of blood capillaries and lymph capillaries was rare. In mildly hyperplastic synovitis, lymph capillaries were observed just beneath the surface of the synovial membrane, whereas blood capillaries occurred in a little deeper layer of the synovial membrane. In a severely hyperplastic synovitis, both lymph and blood capillaries were observed frequently. The present results suggest that the different distribution patterns of lymph capillaries and blood capillaries reflect the degree of synovitis but can not be attributed to specific clinical symptoms.     

Hemangioma of the synovial membrane of the knee joint

The data on 15 patients with hemangioma of the synovial sheath of the knee joint are reported. It is the author's opinion that surgical removal of the tumor is the most radical method of treatment for hemangiomas. Among 15 patients such procedure was accomplished in 6, in the remainder biopsy or partial removal of the tumor followed by radiotherapy were performed. Late results were followed up in 9 patients.     

Immunocytochemical demonstration of reduced glutathione in neurons of rat forebrain

Histochemical studies show reduced glutathione (GSH) in neuroglia, whereas immunocytochemistry of glutaraldehyde-fixed tissue reveals GSH also in neurons. Using an antibody suitable for formaldehyde-fixed tissue, we find GSH staining in the cytoplasm of neurons throughout the brain. Staining was prominent in large pyramidal neurons of cerebral cortex, in basal ganglia, and in reticular and ventrobasal thalamic nuclei.     

Acute suppurative arthritis of the temporomandibular joint. Report of a case

The case reported illustrates a rare but interesting condition. Early treatment is the most important factor in decreasing the high morbidity associated with this infection. Aspiration is a key diagnostic tool for early diagnosis. Surgical intervention should be individually assessed and active physiotherapy is a must to resume normal function of the joint.     

A histochemical study on the acidic glycoconjugates of the synovial membrane in rheumatoid arthritis

The localization and the nature of glycosaminoglycans (GAGs) in the synovial membrane in 30 patients with rheumatoid arthritis (RA) involving 40 knees were studied by newly developed histochemical methods. To detect the acidic glycoconjugates, sensitized diamine procedures were employed based upon high and low iron diamine stainings. To identify the various molecular species of the GAGs, enzyme (chondroitinase ABC and B, testicular hyaluronidase and keratanase) digestion and chemical modification (nitrous acid treatment) procedures were performed prior to the diamine stainings. The sensitized diamine methods could clearly stain the acidic glycoconjugates contained in the synovial tissue components in shades of brown to black, and could detect the precise distribution patterns of the GAGs. The results obtained in the present study confirmed that the tissue in RA synovial membranes contained various amounts of each GAG molecular species such as dermatan sulfate, chondroitin sulfate A/C, hyaluronic acid and heparan sulfate. Furthermore, the distribution patterns of dermatan and chondroitin sulfates in the diseased synovial tissues were pathophysiologically interesting; in the inflammatory areas, the molecular species of GAGs was primarily dermatan sulfate, whereas in the fibrotic areas, it was mainly chondroitin sulfate A/C. Such results appear to be useful for pathophysiological studies on the synovial tissues of RA.     

The activating effect of synovial fluid and washings of synovial membrane on autologous lymphocytes in rheumatoid arthritis

The effect of synovial fluid and washings of synovial membrane on autologous lymphocytes from patients with rheumatoid arthritis and other diseases has been studied using a rapid method based upon the increase in intranuclear birefringence occurring in the early stages of lymphocyte activation. Retardation of polarized light indicating increased lymphocyte activation was seen in lymphocytes from patients with rheumatoid arthritis but not in lymphocytes from patients with other diseases.     

Proteoglycan expression in the rat temporomandibular joint in response to unilateral bite raise

We report the development of a novel time-resolved fluorescence immunoassay utilizing two different assay strategies for the simultaneous measurement of estrone-3-glucuronide (EG) and pregnanediol-3alpha-glucuronide (PG) in samples of early morning urine (EMU). The method for the measurement of EG involves the use of a labeled anti-idiotype as a surrogate antigen, whereas the other method (for the measurement of PG) is a regular competitive immunoassay using a labeled antigen. In addition, the procedure uses different lanthanide chelates as labels to monitor ovarian function in women. After washing the streptavidin-coated plate, we added 10 microL of undiluted urine or mixed standard to the coated wells, followed by the addition of 100 microL of assay buffer containing the labeled reactants (i.e., europium-labeled PG and samarium-labeled anti-idiotype recognizing the binding site of the antibody to EG). Subsequently, we added 100 microL of assay buffer containing the two biotinylated specific monoclonal anti-steroid glucuronide antibodies. After incubation for 1 h on a shaker at room temperature, we washed the plate and added 200 microL of enhancement solution to each well. We measured europium and samarium fluorescence, using a gated plate fluorometer with appropriate emission filters. The method demonstrates appropriate sensitivity and precision (all CVs, 5-8%) across the relevant working ranges for each analyte. The technique has been applied to serial EMUs collected from women with normal and stimulated menstrual cycles.     

Laser arthroscopy of the temporomandibular joint

Laser surgery is very different than traditional surgery. The clinician must be familiar with the physical properties of the laser to use this instrument safely and properly. Various lasers are available for use in oral and maxillofacial surgery and dentistry, namely the carbon dioxide laser, the neodymium:yttrium-aluminum-garnet laser, and the holmium: yttrium-aluminum-garnet laser (Ho:YAG). Only the Ho:YAG laser has been used with effectiveness in temporomandibular joint arthroscopic surgery.     

Direct synovial gene transfer with retroviral vectors in rat adjuvant arthritis

BACKGROUND: The presence of human papillomavirus (HPV) in the prostate and its role in prostate carcinoma are in dispute. To address these issues, two laboratories with extensive HPV experience were selected to test specimens from two populations at different risk for prostate carcinoma, using three different polymerase chain reaction (PCR) assays and two serologic assays for HPV. METHODS: The cases were comprised of 51 African-American (men at high risk for prostate carcinoma) and 15 Italian (men at intermediate risk for prostate carcinoma) men with prostate carcinoma. Controls were 108 African-American men and 40 Italian men with histologically proven benign prostate hypertrophy (BPH). Prostate tissue was obtained from each patient at surgery and immediately frozen in liquid nitrogen. The PCR primer sets included two (MY09/MY11 and GP5+/ GP6+) that amplify different regions of L1 and a third (WD66,67,154/WD72,76) targeted to E6. Sensitivity in the 2 L1 PCR assays was shown to be 1 HPV DNA genome per 100 cells. Serum antibodies to HPV-16 and HPV-11 virus-like particles (VLPs) were detected using enzyme-linked immunosorbent assays. RESULTS: All available prostate carcinoma tissue specimens (n = 63) and BPH specimens from selected controls (n = 61) were tested by PCR. Human beta-globin DNA could be amplified from all specimens except three carcinomas, but no HPV DNA was detected in any case or control specimens by MY09/MY11 or E6 PCR. Microdissection of 27 carcinoma specimens was conducted to minimize nontumor DNA, but results remained negative by MY09/MY11 and GP5+/GP6+ PCR. In addition, serum specimens in cases (n = 63) and controls (n = 144) showed no differences in their responses against HPV-16 (P = 0.54) or HPV-11 VLPs (P = 0.64). CONCLUSIONS: The findings suggest that HPV is not associated with prostate carcinoma, and that HPV DNA is not at all common in the prostate glands of older men.     

Temporomandibular joint disorders and surgery of the temporomandibular joint

Surgery of the TMJ is a useful tool in Temporo Mandibular Disorders (TMD). After have been identified what is part of TMD and what isn't, this article lay stress upon the fact that surgery of the TMJ is the appropriate treatment only when the nonsurgically therapy had failed. Indications, danger and complications are discussed. Procedures of arthrotomy and arthroscopy are explained. Various surgical procedures and staging of TMD are discussed.     

Unscheduled DNA synthesis in lymphocytes of rheumatoid arthritis patients and spleen cells of rats with experimentally induced arthritis

DNA repair is an important factor in the abolition or manifestation of mutations. Since intrinsic somatic mutations may be related to the occurrence of autoimmunity, DNA repair was investigated by measuring unscheduled DNA synthesis in lymphocytes of rheumatoid arthritis patients by autoradiography. Likewise, unscheduled DNA synthesis was investigated in mycoplasma- and Freund's adjuvant-induced arthritis in rats. Both in human rheumatoid arthritis and experimentally-induced arthritis the capacity for repairing lesions in DNA induced by gamma-irradiation of cells was reduced, while an increased rate of thymidine-incorporation into DNA was found after UV-irradiation. The results are discussed in relation to endonucleases of viral or mycoplasmal origin.     

Differentiation of B cells in the nonlymphoid tissue of the synovial membrane of patients with rheumatoid arthritis

In patients with rheumatoid arthritis the synovial membrane of the affected joint is infiltrated with lymphoid cells which may be arranged in structures resembling germinal centers. We have directly isolated such infiltrates to determine whether B-cell clones within them are selected and expanded in a process analogous to that which normally takes place in the germinal centers in secondary lymphoid organs. The data suggest that an antigen-driven process leads to the accumulation of B cells in the synovial membrane. The finding of identical sequences in consecutive sections suggests that under conditions of chronic stimulation, memory B cells may enter a stage of differentiation in which they proliferate without further accumulation of somatic mutations. Further we see intraclonal diversity which underlines the germinal center-like character of these infiltrates and demonstrates that a microenvironment is built up in this nonlymphoid tissue which supports antigen-dependent differentiation of B cells. This is the first demonstration, to our knowledge, of a germinal center-like reaction outside lymphoid tissue.     

Evaluation of the temporomandibular joint in panoramic radiography

It was shown that a single intraperitoneal administration of Bacillus intermedius RNAse to rats stimulated the activity of lysozyme and blood serum complement. A single intraperitoneal administration of pancreatic RNAse, Bacillus intermedius RNAse and its derivative selectively inactivated by the histidine active centre stimulated the metabolic activation of neutrophils as was shown by their ability to reduce tetrazolium nitroblue to diphormazone. The efficiency of the neutrophil stimulation by the RNAses was comparable with that of the microbial vaccine and did not depend on the catalytic activity of the RNAses.     

Effect of high lipid diet and allopurinol on the development of experimentally induced arthritis in rats

Male albino rats were fed a high lipid diet for 5 consecutive weeks. We studied the development of paw inflammation after an injection with Freund's complete adjuvant. Increasing the lipid content of the diet significantly increased the rate of paw inflammation. Also the effect on this process of oral administration of a xanthine oxidase inhibitor (allopurinol, 50 mg/kg) for 15 consecutive days was studied. Results indicated that inflammation was significantly inhibited by allopurinol.     

Stress analysis of the human temporomandibular joint

OBJECTIVE: To examine how dietary intake varies with age in a nation-wide sample of adult Norwegian women, and to evaluate the impact of lifestyle and socio-economic status on important dietary aspects. DESIGN: Cross-section study. SETTING AND SUBJECTS: A food frequency questionnaire was mailed to a random, nation-wide sample of 20 000 women aged 45-69y, and 9885 questionnaires were accepted for nutritional analyses. RESULTS: Dietary habits differed moderately with age. The oldest women reported a higher consumption of potatoes and fish, whereas the youngest reported more coffee, meat, and alcohol. The reported intake of fruit, vegetables, and potatoes was lower than recommended in all age groups. Older women had a slightly better distribution of energy yielding nutrients than younger women, although the median percentage of energy from fat was too high in all age groups. The median dietary fibre density of the diet was close to the recommended level in all age groups, yet lowest among the youngest women. Practising a healthy lifestyle and having a higher socio-economic status were associated with reporting a healthier diet. However, adjusting for lifestyle and socio-economic factors did not substantially alter the associations between diet and age. CONCLUSIONS: Older women tend to have a healthier diet than younger women. The relationship does not seem to be strongly confounded by lifestyle and socio-economic status, although these factors are also related to dietary habits.     

Unilateral medial dislocation of the temporomandibular joint

We present our experience of the rare condition of unilateral medial dislocation of the temporomandibular joint (TMJ) in 11 patients with head trauma who had received a direct lateral blow on the chin. The diagnosis was made by direct coronal CT of the TMJ performed from 6 h to 7 days following the injury. In 6 patients, subcondylar fracture of the ipsilateral mandibular ramus was also demonstrated. A second CT performed 11-16 months following the first one demonstrated pseudoarthrosis of the fractured ramus in these 6 patients. The second CT was identical to the first in the remaining 5 patients with pure dislocation of the condyle. All patients suffered from severe disability of the TMJ. The maximal vertical distance between the upper and lower incisors in patients with uncomplicated dislocation ranged between 8 and 12 mm. In cases with complicated medial condylar dislocation with fracture and pseudoarthrosis of the mandibular ramus, this distance ranged between 16 and 25 mm, probably because of additional movement in the area of the pseudoarthrosis. The maximal vertical distance between the incisors was compared with a control group of 20 normal adults who had values from 40 to 52 mm. Medial unilateral dislocation of the TMJ can appear in two forms: uncomplicated or complicated, with pseudoarthrosis of the ipsilateral mandibular ramus.