Temporomandibular joint arthrography: comparison of morbidity with ionic and low osmolality contrast media

We compared patient morbidity associated with temporomandibular joint (TMJ) arthrography using both meglumine/sodium diatrizoate (60%) and the new monoacidic dimer, Hexabrix, in a double-blind randomized clinical trial in 31 patients. Patients experienced maximal discomfort from TMJ arthrography with the initial joint filling and joint distension; this rapidly resolved over 10 minutes. Delayed exacerbation of pain is less than described for shoulder arthrography. The newer contrast media promise to decrease patient morbidity with arthrography.     

Pycnodysostosis: some aspects concerning kinetics of calcium metabolism and bone pathology.

A 23-year-old white woman suffering pycnodysostosis whose parents and five siblings were unaffected was investigated. Chromosomal morphology was normal. Histologic examination of a biopsy specimen obtained from the distal phalanx of the left thumb, corresponding to an area on an x-ray film of osteolysis, showed a fibrous dysplasia-like picture. Kinetic studies of calcium metabolism revealed that exchangeable pool size, turnover, and bone accretion rate were all decreased. Intestinal calcium absorption was investigated simultaneously by a double isotope technique and by deconvolution of the plasmatic specific activity curve of 47Ca given per os. Results obtained by both methods coincided in that values were found to be similarly increased. Endogenous fecal calcium was also determined and revealed a similar increase. Some physiopathological implications of these findings are discussed.     

Antibiotic-acrylic bone cement composites. Studies of gentamicin and Palacos.

Palacos bone cement with and without contained gentamicin was tested for antibacterial efficacy using a rabbit model of a knee hemiarthroplasty and a challenge with intra-articular Escherichia coli. The gentamicin-containing cement prevented infection from challenge with Escherichia coli and protected against inadvertent operative infection as well. Antibiotic concentrations in synovial fluid and urine remained in the therapeutic range for three days, whereas levels in serum were always quite low. Eight per cent of the gentamicin had leached out of the bone cement by eight days, most of it during the first day. Thereafter, extremely small amounts of gentamicin left the cement on a daily basis. The amount of antibiotic leaching out in vitro was proportional to the surface area of the cement. More eluted into serum than into saline.     

99Technetium bone scanning in experimental osteomyelitis

A rabbit model of experimental osteomyelitis was used in an attempt to clarify the natural history of bone infection associated with positive scintigraphic and negative radiological findings. In this model a pathogenic strain of Staphylococcus aureus is injected in the proximal metaphysis of the tibia of a rabbit, 15 minutes following the injection of a sclerosing agent. Scintigraphies were performed at 3, 5, 12, and 19 days following this procedure; 99m-Technetium phosphate compounds were used indifferently. On days 5, 12, and 19 a roentgenogram of the lower limbs was taken. Animals were sacrificed at random 6, 14, and 21 days following the procedure. Against expectations, the standard radiological procedure was more sensitive than the scintigraphic technique. The probability of finding a positive bone scintigrapy in the presence of osteomyelitis P(S+/O+) was 15/19 or 0.78. For the roentgenograms P(X+/O+) = 16/17 = 0.94. On pathological review the scintigraphic findings remained unexplained when fibrosis, periosteal reaction, granulocytic infiltration, and new bone formation were considered separately. In half of the cases the early scintigraphies revealed decreased uptake on the affected side, but this finding did not predict whether the final scintigraphy was positive. Finally, positivity was obvious in all cases, and a continuous range from negative to positive could not be documented. Present findings are a characteristic feature of the model. The physiological mechanism remains to be explained by independent measurements of relative bone blood flow made simultaneously with the scintigraphy and other bone tissue specific factors.     

Inhibition of interleukin 1 induced chondrocyte protease activity by a corticosteroid and a nonsteroidal antiinflammatory drug.

We report that administration of the corticosteroid, methylprednisolone (PRED) inhibited interleukin 1 (IL-1) induction of chondrocyte caseinolytic activity (25-55%) and collagenolytic activity (15-24%). The nonsteroidal antiinflammatory drug (NSAID), naproxen (NAP) had no effect on either enzyme activity over a therapeutic range (7-30 micrograms/ml) but at 120 micrograms/ml inhibited IL-1 induced caseinolytic and collagenolytic activity by 17 and 19%, respectively. However, PRED (2 micrograms/ml) in combination with NAP (30 micrograms/ml) significantly increased the inhibition of caseinolytic activity (p less than 0.001) compared to that observed with PRED (2 micrograms/ml) alone. The suppression of IL-1 induced collagenolytic activity noted with PRED in combination with NAP did not exceed that observed with PRED alone.     

锌缺乏对神经病理性疼痛模型小鼠行为学的影响

目的研究饮食锌缺乏对神经病理性疼痛模型小鼠痛域的影响。方法制备饮食锌缺乏小鼠,采用小鼠坐骨神经分支选择损伤模型,金属自显影和原子吸收光谱检测小鼠脊髓后角锌稳态,检测小鼠痛域。结果 AMG结果证实,与假手术组相比,模型组小鼠和锌缺乏组小鼠脊髓后角游离锌离子减少,与模型组小鼠相比,锌缺乏小鼠脊髓后角游离锌离子减少。原子吸收光谱结果表明,锌缺乏组小鼠总锌含量较假手术组减少。痛域检测结果表明,锌缺乏小鼠痛域下降。结论锌离子可能参与小鼠脊髓后角痛觉专递。     

姜黄素对癫痫小鼠海马脑损伤的保护作用

目的研究姜黄素对匹罗卡品诱导的癫痫小鼠海马新生神经元和细胞凋亡的影响。方法姜黄素预处理后,小鼠腹腔注射匹罗卡品建立小鼠癫痫模型,应用新生神经元标记物双皮层蛋白(doublecortin,DCX)免疫组织化学染色及TUNEL染色对造模后72h的模型小鼠海马进行检测。结果 DCX免疫组织化学染色结果表明,与对照组相比,模型组及姜黄素处理模型组小鼠海马齿状回DCX阳性细胞明显减少;与模型组相比,姜黄素处理模型组小鼠海马齿状回DCX阳性细胞明显增多。TUNEL染色结果表明,与对照组相比,模型组及姜黄素处理模型组小鼠海马齿状回TUNEL阳性细胞明显增多;与模型组相比,姜黄素处理模型组小鼠海马齿状回TUNEL阳性细胞明显减少。结论姜黄素可能对匹罗卡品诱导的癫痫小鼠海马神经元有保护作用。     

巨大下颌骨囊性病变分期治疗效果评价

目的:探讨对巨大下颌骨囊性病变进行分期治疗的效果。方法:选择2005—2009年在本院收治的下颌骨范围大于5cm的囊性病变18例,其中伴牙列不齐者6例,一期局麻下行减压术,待范围减小至小于原来的1/2后,行二期全麻下囊性病变摘除术,即刻Bio-oss骨粉植入,术后每月定期拍摄口腔全景片观察骨密度变化,伴牙列不齐的6例患者手术后2个月开始以常规正畸加力牵引。结果:一期术后4~6个月,病变减小至原来的1/2左右,二期术后6~12个月,骨粉与周围正常骨密度基本一致,2~3a后无一例复发。6例牙列不齐的患者,经1~2a正畸治疗后,错畸形得以矫正。结论:分期治疗既彻底摘除了病变,又保存了下颌骨的连续性及自体牙,还可同时结合正畸治疗,改善错畸形,提高美学效果。