Lubricin immunohistochemical expression in human temporomandibular joint disc with internal derangement

J Oral Pathol Med (2011) 40 : 587–592 Lubricin is a chondroprotective, mucinous glycoprotein which contribute to joint lubrication, especially to boundary lubrication and maintains joint integrity. The present investigation aimed to study the immunolocalization of lubricin in TMJ discs from patients affected by anterior disc displacement with reduction (ADDwR) ADDwoR. Eighteen TMJ displaced disc affected by ADDwoR were processed immunohistochemically, with a polyclonal anti‐lubricin antibody, used at 1:50 working dilution. The percentage of lubricin immunopositive cells (extent score = ES) and the extent of lubricin staining of the disc extracellular matrix (ECM), were evaluated. Each sample was scored for histopathological changes. Percentage of immunostained surface disc cells was the same (ES = 4) in both control and ADDwOR cells, being this data not statistically significant (P < 0.05). In pathological specimens the percentages of lubricin‐stained cells was very high with an ES of 4 respect to control specimen, and this difference was statistically significant different (P > 0.05). The extracellular matrix (ECM) of discs at the disc surfaces of both pathological and normal specimens was very heavily stained (++++). Both the ES and ECM staining were not statistically correlated to the TMJ degeneration score according to the Spearman’s rank correlation coefficient. According to our findings, a longstanding TMJ disc injury, affects lubricin expression in the TMJ disc tissue and not its surfaces, moreover, lubricin immunostaining is not correlated to TMJ disc histopathological changes.     

Deleterious effects of whole‐body vibration on the spine: A review of in vivo,ex vivo,and in vitro models

Occupational exposure to whole‐body vibration is associated with the development of musculoskeletal, neurological, and other ailments. Low back pain and other spine disorders are prevalent among those exposed to whole‐body vibration in occupational and military settings. Although standards for limiting exposure to whole‐body vibration have been in place for decades, there is a lack of understanding of whole‐body vibration‐associated risks among safety and healthcare professionals. Consequently, disorders associated with whole‐body vibration exposure remain prevalent in the workforce and military. The relationship between whole‐body vibration and low back pain in humans has been established largely through cohort studies, for which vibration inputs that lead to symptoms are rarely, if ever, quantified. This gap in knowledge highlights the need for the development of relevant in vivo, ex vivo, and in vitro models to study such pathologies. The parameters of vibrational stimuli (eg, frequency and direction) play critical roles in such pathologies, but the specific cause‐and‐effect relationships between whole‐body vibration and spinal pathologies remain mostly unknown. This paper provides a summary of whole‐body vibration parameters; reviews in vivo, ex vivo, and in vitro models for spinal pathologies resulting from whole‐body vibration; and offers suggestions to address the gaps in translating injury biomechanics data to inform clinical practice.     

Autoimmunity in intervertebral disc herniation: from bench to bedside

Introduction: The cause of low back pain and the pathophysiology of lumbar pain and sciatica have recently been reconsidered basing on current knowledge on cellular and molecular mediators of inflammation. Several cytokines have been considered as potential therapeutic targets to contrast sciatica in patients with disc herniation, and supportive studies suggest a leading role of TNF-α in this contest: therefore, clinical trials have tested TNF-α inhibitors in the clinical setting of the patient with radicular pain secondary to an herniated disc.

Areas covered: The current review deals with the autoimmune theory of disc herniation and its role in determining radiculopathy and neuropathic pain. It also reports the recent evidences that led to the introduction of anti-TNF-α drugs into the clinical setting as a biological therapy for radiculopathy and disc herniation.

Expert opinion: Targeting the TNF-α pathway has demonstrated controversial effects in the tested study population and available results only report a short-term follow-up. More confirmatory studies in terms of long-term clinical results, complications, more effective route of administration and cost-effective analysis are required to establish the real role of this biological therapy in the treatment of patients with disc herniation and neuropathy.     

Reduced Retinal Nerve Fiber Layer Thickness of the Papillomacular Bundle and Congenital Pit of the Optic Nerve Head

A 32-year-old healthy woman with a history of poor visual acuity of the left eye was found to have a temporal optic nerve head pit, with no leakage on fluorescein angiography. Visual field showed a caecocentral scotoma, more profound at the location related to the pit. Optical coherence tomography showed the characteristics of the optic pit and excluded signs of previous macular detachment; Moreover, it disclosed a significantly reduced retinal nerve fiber layer thickness at the papillomacular bundle. Thus, reduction of the papillomacular bundle is an additional cause of poor visual acuity in cases of optic pit.     

Bilateral Nongranulomatous Uveitis with Infective Endocarditis

A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.     

阳和汤治疗老年腰间盘突出症临床观察

目的分析对大于60岁腰间盘突出症的患者行阳和汤加味治疗的效果。方法资料选取本院2014年9月—2015年9月收治的60岁腰间盘突出症120例患者进行回顾性分析,根据治疗时方案分成两组,将行常规西药治疗的54例患者设为对照组,将在对照组基础上行阳和汤加味治疗的66例患者设为观察组,对两组具体治疗效果进行对比。结果观察组总有效率比对照组高,且腰腿疼痛、间歇性跛行发生率比对照组低(P0.05)。结论大于60岁腰间盘突出症的患者行阳和汤加味治疗有利于改善患者临床症状,具有一定临床应用价值。     

Experimental Study on Stress Relaxation and Creep Properties of Human Thoracolumbar Vertebral Bodies and Intervertebral Discs

Objective：Underwater shock can produce extremely high accelerations, resulting in severe human injuries on shipboard, and human thoraco lumbar spines are prone to suffer from injuries by ship shock motion. To observe the viscoelasticity of thoracolumbar of young fresh cadavers, and to provide biomechanical parameters for both research and clinical practice. Materials and Methods：5 fresh young male cadavers （aged 22 to 31 years） were provided, and 15 thoracolumbar spinal anatomies of 5 samples were harvested within 1 hour of death. WE-10A universal testing machine was used for creep and relaxation tests.Results：Stress relaxation and creep deformation equations are derived from the biomechanics model and the measured and simulated curves are compared. The creep in vertebral bodies and intervertebral discs exhibited significantly changes in the first 5 min and 10 min, respectively. The stress rapidly decreased in the first 2 min, and then gradually went balance during the relaxation process. Conclusion：The change in creep rate is significant at early stage,and gradually slows down.This indicates that the differences between internal pressure and local pressure are decreased until balance. The simulated curve derived from equation coincides with the experimental data to a large degree, which states that the equation is rational and reliable.     

Diagnostic significance of topical Image of infrared thermography on the patients with lumbar intervertebral disc protrusion —a comparative study on 45 patients with Manipulative treatment and 65 normal control

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经皮穿刺腰椎间盘切除术与透明质酸钠联合治疗腰椎间盘突出症

目的　研究经皮穿刺腰椎间盘切除术 (PL D)与透明质酸钠联合治疗腰椎间盘突出症的疗效。方法　 48例患者随机分为两组 ,采用经皮穿刺 PL D联合透明质酸钠骶管注射 (治疗组 ) 2 6例 ,单纯经皮穿刺 PL D(对照组 ) 2 2例。术后每 3个月随访一次 ,至术后 2年 ,根据改良的 Macnab标准判断疗效。结果　治疗组痊愈 16例 ,显效 5例 ,有效 4例 ,无效 1例。显效率为 80 .77%。对照组痊愈 8例 ,显效 7例 ,有效 5例 ,无效 2例。显效率为6 8.18%。两组疗效比较 ,有统计学意义 (P<0 .0 5 )。结论　腰椎间盘切除术与透明质酸钠联合治疗具有疗程短、见效快及安全等优点 ,是穿刺治疗腰椎间盘突出症的一种理想方法