Complications of temporomandibular joint arthroscopy: a retrospective analytic study of 670 arthroscopic procedures.

PURPOSE: Temporomandibular joint (TMJ) arthroscopy has been considered a safe surgical procedure in the treatment of TMJ derangement. However, it is not exempt from complications. This study evaluates the complications of arthroscopy in patients with internal derangement of TMJ. PATIENTS AND METHODS: Five hundred consecutive patients (670 joints) with TMJ derangement who underwent arthroscopy between 1995 and 2004 were retrospectively analyzed. All the patients were classified as II to V in the Wilkes classification. Lysis and lavage, electrocautery of the posterior ligament, injection of corticoids, injection of ethanolamine, myotomy of lateral pterygoid muscle attachments, myotomy and electrocautery, motor debridement, injection of sodium hyaluronate, and meniscal suture were performed in different patients. RESULTS: Complications were recognized during or immediately after the surgery. They were observed in 5 of 341 (1.26%) arthroscopies of the right TMJ and 4 of 329 (1.21%) arthroscopies of the left TMJ. A 1.34% complication rate was found in the whole series. No blood clots within the external auditory canal were observed. Bleeding within the superior TMJ space was observed in 57 cases (8.5%), 36 of them in the right TMJ and 21 in the left TMJ, but they were not considered as true complications. Lacerations of the external auditory canal were found in 2 cases (0.3%), with no cases of perforation of the tympanic membrane. Lesion of the auriculotemporal nerve was observed in a case. Paresia of the facial nerve was found in 4 cases (0.6%). Alteration of visual accuracy of the ipsilateral eye was also observed in a patient immediately after the surgery. CONCLUSION: Special care must be taken to reduce complications within the upper joint space by means of an adequate instrumentation and by paying attention to essential points of the arthroscopic technique.     

Cytokeratin expression in squamous-cell metaplasia of the cervix uteri: an immunohistochemical study using monoclonal antibodies]

Immunohistochemical study of the exo- and endocervix in squamous metaplasia is performed using EE21-06d monoclonal antibodies revealing simultaneously five cytokeratinous polypeptides characteristic of squamous epithelium, and f-12-19h revealing simultaneously wide spectrum of cytokeratinous polypeptides characteristic of the epithelium various types. PAP method and the reaction of immunofluorescence were used. Monoclonal antibodies 12-19d label cells of all layers of normal exocervix, endocervix and metaplastic squamous epithelium, both immature and differentiated. Monoclonal antibodies EE21-06d react in the exocervix with suprabasal and higher located cells and in the endocervix with reserve cells only. Positive reaction with EE21-06d in the metaplastic foci increases in proportion with the squamous cell differentiation, thus this antibody being the marker of reserve cells and the degree of the squamous metaplasia maturity.     

A novel fungal prenyl diphosphate synthase in the dimorphic zygomycete Mucor circinelloides

Two Mucor circinelloides structural genes involved in isoprenoid biosynthesis were isolated and characterised. The isoA gene encodes a typical eukaryotic farnesyl diphosphate synthase (EC 2.5.1.10), whereas the isoB gene deduced amino acid sequence shows similarity to fungal medium-chain prenyl diphosphate synthases. By functional complementation in Escherichia coli, the isoB gene product was shown to be a solanesyl diphosphate synthase (EC 2.5.1.11), which is the first fungal enzyme reported having this specificity. In addition, a M. circinelloides one-marker-per-chromosome map was completed by contour-clamped homogeneous electric field localisation of isoA, isoB and three other isoprenoid biosynthesis genes to individual chromosomes.Abbreviations FPP farnesyl diphosphate (or pyrophosphate) - GGPP geranylgeranyl diphosphate - PrenylPP prenyl diphosphate - DPP decaprenyl diphosphate - HPP hexaprenyl diphosphate - SPP solanesyl diphosphate     

Morphological characteristics and immunophenotype of dendritic cells generated from monocytes of human peripheral blood

Morphological features and immunophenotype of mature dendritic cells (DC) generated from the monocytes of healthy donor blood after culture with GM-CSF and IL-4 with the addition of TNF, were studied using light and electron microscopy, as well as flow-cytometry. It was shown that DC were characterized by a number of morphological features such as: large size, eccentrically located nucleus, highly developed system of extensions, large vacuolated cytoplasm, prominent and activated Golgi complex and ribosomal apparatus. Mature DC are characterized by active surface expression of MHC and co-stimulatory molecules (MHC I, MHC II, CD40, CD80, CD86).     

Ultrastructural tissue-specific signs of the cells of cancerous tumors of the human breast

Ultrastructural analysis of mammary carcinoma (45 cases) and its metastasis in the lymph nodes (21 cases) revealed the tissue specific features of the mammary gland: big ducts and intercellular canaliculi, microvilli, various specialized cell-to-cell contacts, basal membrane. Tissue specific features are not associated with a certain organ. In mammary carcinoma, they are more pronounced in carcinomas in situ, invasive tumours of the 1st grade of malignancy (adenocarcinoma) and specific histologic variants. They are less pronounced in solid and scirrhous invasive tumours of the 2nd and especially 3rd grade of malignancy. However it is impossible to conclude about the anaplasia degree on the basis of the number of and the correlation between various tissue specific features. Metastasis retains the capacity of cancer cells to form the tissue specific ultrastructural elements. The tissue specific properties of mammary carcinoma determine the diagnosis in cases when the question on the tissue origin of the tumour is to be solved.     

Results of the electron microscopic diagnosis of human tumors (an analysis of 1000 cases)

A review of electron-microscopic diagnostic investigations made on biopsy specimens from 1000 patients showed the range of tumors requiring ultrastructural diagnosis to be fairly broad, encompassing virtually all major tumor sources including soft tissues (37% of the cases), epithelium (31.8%), hematopoietic organs (21.3%), pigment-forming tissues (4.9%), and bones (3.3%). The tissue and cellular origin of the tumor was identified, i.e. a differential diagnosis was correctly made and/or the histogenetic (cytogenetic) type of the tumor was established, in most (83.0%) of the cases, whereas the organ of tumor origin was identified in only 6.0%. Electron-microscopically, the histological diagnosis was confirmed in 45.3% of the cases, made more precise in 19.0%, and discarded in 5.1%; in 5.8%, electron microscopy confirmed as correct one of the diagnoses presumed on histologic grounds, while in 3.9% the diagnosis could not be verified because the tumors consisted of undifferentiated cells in their entirety. Historic material (formalin-fixed or from paraffin blocks) and stained histologic sections were used for the ultrastructural diagnoses.     

A complex composed of USF1 and USF2 activates the human FcepsilonRI alpha chain expression via a CAGCTG element in the first intron

The high-affinity IgE receptor, FcepsilonRI, is a key regulatory molecule in the allergic reaction. During the course of studies to find cis-acting elements for FcepsilonRI alpha chain gene expression, a CAGCTG sequence located in the first intron was revealed to serve as a crucial enhancer element. Electromobility shift assays using antibodies and in vitro translation products showed that the CAGCTG element was recognized by the USF1/USF2 complex. As was the case for other intronic cis-elements, the CAGCTG element regulated the promoter in an orientation- and position-dependent manner. Overexpression of USF2 antisense repressed the FcepsilonRI alpha chain gene promoter and decreased the amount of alpha chain mRNA in mast cell lines. All these results indicated that the USF1/USF2 complex activates the human FcepsilonRI alpha chain gene expression via the CAGCTG element in the first intron.