Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders

Objective: Clinical tests used to examine patients with temporomandibular disorders vary in methodological quality, and some are not tested for reliability. The purpose of this cross-sectional study was to evaluate inter-tester reliability of clinical tests and a cluster of tests used to examine patients with long-lasting temporomandibular disorders.

Methods: Forty patients with pain in the temporomandibular area treated by health-professionals were included. They were between 18–70 years, had 65 symptomatic (33 right/32 left) and 15 asymptomatic joints. Two manual therapists examined all participants with selected tests. Percentage agreement and the kappa coefficient (k) with 95% confidence interval (CI) were used to evaluate the tests with categorical outcomes. For tests with continuous outcomes, the relative inter-tester reliability was assessed by the intraclass-correlation-coefficient (ICC_3,1, 95% CI) and the absolute reliability was calculated by the smallest detectable change (SDC).

Results: The best reliability among single tests was found for the dental stick test, the joint-sound test (k = 0.80–1.0) and range of mouth-opening (ICC_3,1 (95% CI) = 0.97 (0.95–0.98) and SDC = 4 mm). The reliability of cluster of tests was excellent with both four and five positive tests out of seven.

Conclusion: The reliability was good to excellent for the clinical tests and the cluster of tests when performed by experienced therapists. The tests are feasible for use in the clinical setting. They require no advanced equipment and are easy to perform.     

IMMPACT recommendations for clinical trials: opportunities for the RDC/TMD

The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations for core domains and measures of outcome in clinical trials complement the parallel work completed on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The overall approach of the RDC/TMD is consistent with the IMMPACT recommendations, although the specific tools used to quantify clinical presentation are appropriately different based on the precedents established in the TMD literature. The IMMPACT recommendations, while directed at clinical trials, have broad utility for all clinical research in TMD. Future TMD studies should consider including a measure of health-related quality of life and tracking participant disposition, as well as tracking adverse events from treatment and assessing the participant's global assessment of change in clinical trials. The RDC/TMD methodology provides a rich basis upon which to develop standards for quantifying the clinical significance of treatment outcomes across multiple domains, an area ripe for development. Axis II may benefit from a shift in conceptualisation in which measurement focuses on screening for depression and somatisation to a new, dimensional approach in which Axis II domains are measured and evaluated on a continuum of symptom severity. Combined with the expansion of Axis II to include measures of catastrophising and sleep disturbance, the resulting approach may provide a powerful method for evaluating risk profiles associated with poor outcomes in TMD.     

Harnessing drug resistance: using ABC transporter proteins to target cancer cells

The ATP-binding cassette (ABC) class of proteins is one of the most functionally diverse transporter families found in biological systems. Although the abundance of ABC proteins varies between species, they are highly conserved in sequence and often demonstrate similar functions across prokaryotic and eukaryotic organisms. Beginning with a brief summary of the events leading to our present day knowledge of ABC transporters, the purpose of this review is to discuss the potential for utilizing ABC transporters as a means for cellular glutathione (GSH) modulation. GSH is one of the most abundant thiol antioxidants in cells. It is involved in cellular division, protein and DNA synthesis, maintenance of cellular redox status and xenobiotic metabolism. Cellular GSH levels are often altered in many disease states including cancer. Over the past two decades there has been considerable emphasis on methods to sensitize cancer cells to chemotherapeutics and radiation therapy by GSH depletion. We contend that ABC transporters, particularly multi-drug resistant proteins (MRPs), may be used as therapeutic targets for applications aimed at modulation of GSH levels. This review will emphasize MRP-mediated modulation of intracellular GSH levels as a potential alternative and adjunctive approach for cancer therapy.     

颞下颌关节紊乱病合因素与龋因素的相关性研究

目的：探讨合因素、龋因素与颞下颌关节紊乱病（TMD）致病关系和作用机理。方法：以问诊及临床检查方式,调查石河子市第二中学即将高考体检的学生,采用TMD、龋临床诊断标准和安氏分类等方法,对680名高三学生进行流行病学调查。结果：受测人群中,正常合TMD阳性率为9.5%,异常合TMD阳性率为39.2%,二者差异有统计学意义（P〈0.05）;无龋病者TMD阳性率为22.9%,龋病者TMD阳性率为40.7%,二者差异有统计学意义（P〈0.05）。结论：异常合、龋病是TMD的致病因素之一。     

Putting proteins in their place: palmitoylation in Huntington disease and other neuropsychiatric diseases

Post-translational modification of proteins by the lipid palmitate is critical for protein localization and function. Palmitoylation is regulated by the opposing enzymes palmitoyl acyltransferases (PATs) and acyl protein thioesterases, which add and remove palmitate from proteins, respectively. Palmitoylation is particularly important for a number of processes including neuronal development and synaptic activity in the central nervous system. Dysregulated palmitoylation contributes to neuropsychiatric disease. In total six PATs (HIP14, HIP14L, ZDHHC8, ZDHHC9, ZDHHC12, and ZDHHC15) and one thioesterase (PPT1) have been implicated in Huntington disease (HD), Alzheimer disease, schizophrenia, mental retardation, and infantile and adult onset forms of neuronal ceroid lipofuscinosis. Currently there is no genetic link between PATs and Alzheimer disease pathogenesis but palmitoylation of amyloid precursor protein-processing enzyme, γ-secretase, influences β-amyloid generation. Several lines of evidence point to a role for palmitoylation by HIP14 in the pathogenesis of HD; HIP14 is dysfunctional in the presence of the HD mutation and Hip14-deficient mice develop features of HD. Wildtype huntingtin (the protein mutated in HD) enhances the PAT activity of HIP14 and mutant HTT interacts less with HIP14. Therefore, it may be that loss of the positive modulation of HIP14 activity due to reduced interaction with huntingtin is important in the disease mechanism. Preliminary evidence suggests a closely related PAT to HIP14, HIP14L, may also play a role in the pathogenesis of HD. In order to design rational therapeutic approaches to restore palmitoylation in neuropsychiatric disease, it will be critical to better understand the relationships between PATs and thioesterases with their regulators and substrates.     

Development of perceptual correlates of reading performance

Performance on perceptual tasks requiring the discrimination of brief, temporally proximate or temporally varying sensory stimuli (temporal processing tasks) is impaired in some individuals with developmental language disorder and/or dyslexia. Little is known about how these temporal processes in perception develop and how they relate to language and reading performance in the normal population. The present study examined performance on 8 temporal processing tasks and 5 language/reading tasks in 120 unselected readers who varied in age over a range in which reading and phonological awareness were developing. Performance on all temporal processing tasks except coherent motion detection improved over ages 7 years to adulthood (p<0.01), especially between ages 7 and 13 years. Independent of these age effects, performance on all 8 temporal processing tasks predicted phonological awareness and reading performance (p<0.05), and three auditory temporal processing tasks predicted receptive language function (p<0.05). Furthermore, all temporal processing measures except within-channel gap detection and coherent motion detection predicted unique variance in phonological scores within subjects, whereas only within-channel gap detection performance explained unique variance in orthographic reading performance. These findings partially support the (Farmer, M.E., Klein, R.M., 1995. The evidence for a temporal processing deficit linked to dyslexia: A review. Psychon. Bull. Rev. 2, 460-493) notion of there being separable auditory and visual perceptual contributions to phonological and orthographic reading development. The data also are compatible with the view that the umbrella term "temporal processing" encompasses fundamentally different sensory or cognitive processes that may contribute differentially to language and reading performance, which may have different developmental trajectories and be differentially susceptible to pathology.     

SNARE protein regulation of cardiac potassium channels and atrial natriuretic factor secretion

Coordinated cardiac ion channel gating is fundamental for generation of action potential and excitability throughout the myocardium. The interaction of pore-forming ion channels with auxiliary subunits can regulate surface expression, localization and anchoring of these channels to plasma membrane. SNARE (soluble N-ethylmaleimide sensitive factors attachment protein or SNAP receptor) proteins mediate the targeting, docking, and fusion of intracellular vesicles for exocytotic release of neurotransmitters and hormones. In secretory neurons and neuroendocrine cells, some voltage-gated channels are physically coupled with SNARE proteins, resulting in alterations in channel gating and trafficking. Coupling of SNARE proteins to membrane ion channels is however not unique to secretory cells. We have demonstrated the expression of SNARE proteins in rodent myocardial tissue, and more importantly, functional interaction of SNARE proteins with cardiac K_ATP and K_v (K_v1.2, K_v2.1, K_v4.2, K_v4.3, and K_v11.1) channels. SNARE proteins, therefore, have similar fundamental functions in ion channel trafficking and regulation per se, independent of secretion. We now review the body of work of SNARE protein regulation on membrane ion channels in the heart.     

三磷酸腺苷结合盒转运体A1蛋白第二跨膜结构域缺失突变体的构建及其抗砷性研究

 目的 检测三磷酸腺苷结合盒转运体A1（ABCA1）蛋白第2跨膜结构域(the second transmembrane domain,TMD2)中关键的抗砷结构域。方法 采用重叠区扩增基因拼接法构建三磷酸腺苷结合盒转运体A1基因TMD2的一系列缺失突变体,分别转染至HeLa细胞,激光共聚焦观察其定位,Cell Counting Kit-8检测48 h急性砷中毒后生存率的变化,原子荧光吸收光谱法检测细胞内的总砷含量。结果 激光共聚焦证实各突变体的编码蛋白均定位在HeLa细胞的细胞膜上。CCK-8结果显示,转染胞外第4、5环,胞内第4、5环缺失突变体的HeLa细胞IC₅₀分别为33.18、32.84、33.45、34.29 μmol·L^-1,与转染野生型三磷酸腺苷结合盒转运体A1质粒的HeLa细胞(IC₅₀为33.96 μmol·L^-1)无显著差异,均高于空载体转染对照组(IC₅₀为19.01 μmol·L^-1)。转染胞外第6环缺失突变体HeLa细胞的IC₅₀为19.95 μmol·L^-1,与空载体对照组无显著差异,显著低于野生型三磷酸腺苷结合盒转运体A1质粒转染组。原子荧光分光光度法结果显示,转染胞外第6环缺失三磷酸腺苷结合盒转运体A1的HeLa细胞内砷含量与转染空载体接近,而转染其他突变体的结果与转染野生型三磷酸腺苷结合盒转运体A1的结果基本一致。结论 成功构建了5个三磷酸腺苷结合盒转运体A1蛋白第2跨膜结构域的缺失突变体,且其表达的蛋白仍然正确定位于HeLa细胞的细胞膜上。突变体（除胞外第6环外）仍然具有一定的抗砷性,提示三磷酸腺苷结合盒转运体A1胞外第6环可能是关键抗砷结构域。     

Pantographic reproducibility of mandibular border movements in patients with craniomandibular disorders

The change of the reproducibility of maximum border movements in patients with CMD has been studied in the United States. Clayton and others reported a change of PRI, pantographic reproducibility index. There is no information on this in the Japanese population. Also, there is found no study on each section of a scribed line, pantographic reproducibility value (PRV). The purpose of this study is to analyze each section’s characteristics with a Japanese population. 30 craniomandibular disorder patients were used in study. The Denar pneumatic pantograph has used. The average PRI before treatment was 35.5 and after treatment was 14.8 Statistically significant correlation (r=0.56) was found in PRI between before and after treatment. All 12 sections showed a stasistically significant difference in PR value between before and after treatment. Sensitive sections were: 1. posterior horizontal rotating path early part; 2. posterior horizontal orbiting path later part; 3. posterior horizontal rotating path later part.

     

Statistics for the analysis of tenderness score summation in patient with craniomandibular disorders

Digital palpation has been used to evaluate patients with craniomandibular disorders. Tendemess at each site is classified on a 0 to 3 scale and evaluated as total summation. Tendernes were ranked on the scale. Nonparametric statistics were applied to analyze these data. 34 kind 64 sites makes 192 steps in total summation. Increase of step yielded similer results in parametric and nonparametric statistics. The purpose of this study is to clarify the difference in results between nonparametric and parametric statistics. 100 female CMD patient data were used to make group of 13, 25, 50 and 100 subject group. 16 kind 30 sites, 23 kind 44 sites and 34 kind 64 sites were anlysed as summation. The Wilcoxon test and t-test were used to analyse before and after treatment data. The Spearman’s correlation coefficient and Pearson’s correlation coefficient were analyzed. In the probability, nonparametric statistics always showed more conservative result than parametric statistics. Discrepancy between nonparametric and parametric statistics decreased with an increase of the number of subjects. With 50 subjects, the maximum discrepancy was 0.0011. Discrepancy between correlation also decreased with an increase of the number of subjects. With 50 subjects, the maximum discrepancy was 0.0095. There found very little difference if the number of subjects is more than 50.