Clinical, microscopical and biochemical investigation of synovial fluid from temporomandibular joints

Abstract – The aim of this study was to investigate the relationship between pain and tenderness to palpation of the temporomandibular joint (TMJ), radiographic changes of the joint and signs of inflammation in the synovial fluid. Saline was injected into and aspirated from the TMJ of 29 patients with painful and tender TM joints and from five individuals with healthy joints. In another two patients synovial fluid could be aspirated without saline. The aspirated fluid was analyzed for inflammatory cells and for plasma proteins. A clinical examination of the stomatognathic system and a radiographic examination of the TMJ were performed before the aspiration. Besides tenderness to palpation of the TMJ, pain on mandibular movement and tenderness to palpation of the masticatory muscles were common. Erosion of the cortical outline of the joint surfaces was the most common radiographic finding. Inflammatory cells were present in the fluid of three patients but in none of the healthy individuals. Plasma proteins of inflammatory type could be detected in the fluid from seven of the patients. The results show that radiographic, cellular or biochemical signs of inflammation can frequently be found in the TMJ of patients with longstanding pain and tenderness of this joint.     

MIXED LEUKOCYTE REACTION AND HL-A SPECIFICITY AT MULTIPLE SCLEROSIS

Compared with the mixed leukocyte reaction (MLR) between cells from healthy individuals, the MLR between cells from two patients with multiple sclerosis (MS) is, on average, reduced in strength. There is a tendency for the most marked reduction of MLR to occur when both or neither of the members in a tested pair carry HL-A7, and when cells from patients in a relatively early stage of the disease (short duration, relapses but no permanent disablement) are studied; especially when cells from these patients are used as reactor clels in the MLR. Repeated studies of the same cell combinations with varying intervals showed that when both members of the pair carry HL-A7,--and therefore have a large chance also to carry LD-7a--the MLR strength is relatively constant. When only one or neither of the members carry HL-A7, the strength of MLR varies considerably. Probably two different mechanisms exist in MLR impairment: similarity of LD genes, and "immunosuppressive" factors which can vary during the course of the disease.     

Clinical findings in the stomatognathic system in ankylosing spondylitis

Abstract – 100 individuals with ankylosing spondylitis (AS-group) and a comparison group comprising 57 individuals (C-group) were examined for clinical symptoms from the stomatognathic system and occlusion. It was concluded that the AS-group differed significantly from the C-group with respect to mandibular mobility, tenderness to palpation of the temporomandibular joint and relation between the retruded and intercuspal position of the mandible. Clinical symptoms in the stomatognathic system were correlated to subjective general joint symptoms in the AS-group. Occlusal factors may also be of importance for the development of clinical symptoms in the stomatognathic system in this group.     

Effects of Dietary Supplementation with n-6 and n-3 Long-chain Polyunsaturated Fatty Acids on Serum Lipoproteins and Platelet Function in Hypertriglyceridaemic Patients

ABSTRACT Twenty-seven patients with hypertriglyceridaemia were given dietary supplementation either with evening primrose oil rich in gammalinolenic acid (GLA, 18: 3 n-6) (n=13) or a marine oil concentrate containing n-3 fatty acids (n=14) in a double-blind cross-over design during 8+8 weeks with olive oil as placebo. During GLA supplementation, increases in GLA and dihomogammalinolenic acid (20: 3 n-6) were found in plasma lipid esters and platelet phospholipids, whereas platelet function and serum lipoproteins were unaffected. During supplementation with n-3 fatty acids there was a significant decrease in triglycerides in all lipoprotein fractions with a slight increase in high density lipoprotein and low density lipoprotein cholesterol. A marked increase in the long-chain n-3 fatty acids was found both in plasma and platelets, mainly at the expense of the n-6 fatty acids. No pronounced effects on platelet reactivity could be demonstrated. Our results confirm a triglyceride-lowering effect of n-3 fatty acids, whereas no such effect of GLA could be demonstrated.     

Prenalterol as Long-term Therapy for Chronic Congestive Heart Failure

Abstract Ten patients with severe chronic congestive heart failure (CHF) due to ischaemic heart disease treated with digitalis and diuretics were randomly allocated to oral treatment with prenalterol (100–200 mg daily in addition to their basal treatment) or to intensified treatment with diuretics in a cross-over trial. A wash-out period of 1–4 weeks was allowed between the two modes of treatment. Most of the patients demonstrated subjective improvement during prenalterol therapy, but this improvement could not be verified objectively by exercise test, echocardiography, chest X-ray or weight measurements. No serious side-effects of either mode of treatment were observed. Heart rate was significantly lower during exercise when the patients were treated with prenalterol than during the control periods or during intensified conventional treatment, indicating that prenalterol acts as a β-adrenergic receptor blocker during exercise in this patient group. The results indicate that prenalterol is a partial β-receptor agonist without superior beneficial effects compared to those of intensified conventional treatment in patients with chronic, severe CHF.     

One-Month versus Six-Month Therapy with Oral Anticoagulants after Symptomatic Deep Vein Thrombosis

ABSTRACT. The length of time for which deep vein thrombosis (DVT) should be treated with oral anticoagulants (OA) is controversial. In this study, 135 patients with symptomatic first period DVT (83 % with proximal DVT) were randomly allocated to OA for one or six months. The diagnosis of initial and recurrent DVT was confirmed by phlebography or plethysmography and thermography, or by a combination of all these methods. Pulmonary emboli were confirmed by lung scans or at autopsy. The patients were followed for at least one year. One patient had to discontinue OA prematurely because of haemorrhage. Seventeen patients left the project for other reasons, ten during and seven after therapy; in one of these DVT recurred. The recurrence rate during the first year was high (17% symptomatic recurrences) irrespective of whether OA had been given for one or six months.     

Iron Metabolism and “Sports Anemia”

Abstract Several reports have suggested that iron deficiency might explain “sports anemia” especially in long distance runners. The present study was made to further study the iron metabolism in runners as the proposed cause of “sports anemia” is abstruse considering the good iron nutrition in these athletes. Based on a screening of 43 elite male runners, using bone marrow hemosiderin, serum ferritin and transferrin saturation, two groups of subjects were selected for a very extensive study on iron metabolism. In group 1 (n=5) iron depletion was suggested in at least one of the screening studies. In group 2 (n=7) at least one test strongly indicated good iron repletion. This experimental design was chosen to obtain two groups with similar body composition and exercise load but different iron metabolism. The studies comprised determinations of red cell and plasma volumes, plasma iron turnover and red cell incorporation of radioiron, red cell indices, plasma iron and transferrin, red cell protoporphyrin, serum ferritin, serum haptoglobin, urinary iron losses, iron absorption, bone marrow hemosiderin, dietary intake of energy and nutrients and a Desferal test. Pooling the results together it was obvious that none of the subjects were truly iron-deficient. A few occasional findings suggesting low iron stores cannot be satisfactorily explained and indicate that further studies are needed     

AN EPIDEMIOLOGICAL STUDY OF HYPOSPADIAS IN SWEDEN

The prevalence at birth of hypospadias started to increase in the beginning of the 1970s, as judged from the registration in the Swedish Register of Congenital Malformations. Further studies supported the notion that the increase was real and not due to registration artifacts. A study of the geographical distribution showed an uneven distribution in the country. Three case-control studies with different design were performed in order to find an aeti-ological factor which could explain the observations. None was found. No support could be obtained for a role of gestagens in the aetiology of hypospadias. A hypothesis is presented based on an observation of a possibly increased infertility—possibly male—in the couples who had a boy with hypospadias. The possible implications of this finding for aetiological studies are discussed in the light of current literature. Based on a possible male subfertility, a hypothesis is presented which could explain the noticed increase in prevalence of hypospadias in the early seventies.
The hypospadiac infants were analysed from various points of view. There were signs of a generally disturbed fetal development. Thus a shorter than normal gestational age with a component of growth failure was found. There was a statistically significant association, not only with other genital malformations such as retentio testis, but also with congenital heart disease, cleft lip/palate, anal atresia, and neural tube defects. The analysis indicates that this association was not random, but possibly indicates common teratogenic pathways.