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Biomedical subjects

A Holmlund

Publications and source records attributed to A Holmlund.

At least 19 recordsLinked to original sources
PubMed2005

Expression of proteoglycan mRNA in patients with painful clicking and chronic closed lock of the temporomandibular joint.

RT-PCR was used to analyze the expression of a series of mRNAs coding for proteoglycans aggrecan, versican, biglycan, decorin, fibromodulin and also hyaluronan synthase 1 in specimens obtained during discectomy of the temporomandibular joint in patients with unilateral signs and symptoms of chronic closed lock (eight patients) and painful clicking (seven patients). Regarding the disc, aggrecan expression was higher in patients with chronic closed lock. As for the posterior disc attachment specimens, patients with chronic closed lock showed a tendency for higher expression of biglycan and hyaluronan synthase 1. The degradation of matrix in patients with chronic closed lock of the temporomandibular joint seems not to be caused by a reduced synthesis and the degenerative process seen in these patients is one with low turnover similar to the situation in primary osteoarthrosis of hyaline cartilage. The results indicate that any treatment should intervene early in the disease process of chronic closed lock in order to prevent the development of a degenerative process.

Adult↗
PubMed2003

Inflammatory cell and cytokine patterns in patients with painful clicking and osteoarthritis in the temporomandibular joint.

The occurrence of a subset of cytokines and leukocytes in the posterior disc attachment area of the temporomandibular joint (TMJ) was investigated in two patient groups, i.e, one group with painful clicking and one with osteoarthritis. Synovial biopsies were taken during discectomy in 19 patients with painful clicking and 20 with osteoarthritis. One set of specimens was examined with immunohistochemistry, using frozen sections postfixed by para-formaldehyde and with the cell membranes permeablized in saponin. These sections were incubated with antibodies against cytokines IL-1alpha, IL-1beta, IL-1ra, TNFalpha, IFNgamma, IL2 in all patients and TGFbeta1,2,3 in 16. The other set of specimens was used to characterize cell infiltrates using immunohistochemistry with monoclonal antibodies against antigens CD68 and CD45RO, respectively. Moreover, PCNA was included as a marker for cell proliferation. The cytokine staining was most frequently positive for IL-1alpha and IL-1beta in both patient groups. However, joints with OA showed a more complex cytokine pattern, also involving IFN-gamma (P = 0.019), IL-ra (P = 0.047), and apparently but without reaching the chosen level of significance, IL-2, TNF-alpha and TGF-beta1,2,3. Positive staining for CD45RO was frequent in both groups. OA patients showed more frequently positive staining for CD68 (P = 0.025) and apparently for PCNA.

Antigens, CD↗
PubMed2002

Soluble intercellular adhesion molecule-1 is related to endothelial vasodilatory function in healthy individuals.

OBJECTIVE: To investigate the associations between markers of systemic and vascular inflammation, and indicators of vascular morphology and function. METHODS: In 59 apparently healthy individuals, we measured serum levels of highly sensitive C-reactive protein (hsCRP), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin. Endothelium-dependent (EDV) and -independent (EIDV) vasodilatation was evaluated in the forearm by venous occlusion plethysmography and local infusions of methacholine and sodium nitroprussid. Endothelial function index (EFI) was expressed as the EDV/EIDV ratio. The intima-media thickness (IMT) of the common carotid artery was investigated with ultrasound (far wall). RESULTS: EFI was inversely related only to ICAM-1 (r=-0.31, P<0.02) by univariate analysis. This association remained significant after adjustment for age, sex, blood pressure, smoking and serum cholesterol. EFI did not relate to hsCRP, VCAM-1 or E-selectin. Neither hsCRP, nor the adhesion molecules were significantly related to carotid artery IMT. CONCLUSION: ICAM-1 was related to endothelial vasodilatory function, but not to IMT, suggesting that endothelial inflammatory activation is related to an impaired vascular relaxation in apparently healthy individuals.

Adult↗
PubMed1994

Efficacy of arthroscopic lysis and lavage in patients with chronic locking of the temporomandibular joint.

This prospective 1-year follow-up investigated the efficacy of temporomandibular joint lysis and lavage in relation to arthroscopic diagnoses. The study comprised 42 patients. Clinical evaluation was performed before surgery and at regular intervals up to 1 year postoperatively. Diagnostic arthroscopy and immediately subsequent lysis and lavage were performed under local anesthesia in all patients. Only unilateral upper compartment arthroscopies were executed. The results were evaluated according to the 1984 criteria of the American Association of Oral and Maxillofacial Surgeons. Osteoarthrosis was diagnosed arthroscopically in 30 joints (71%), 21 of which (70%) had more pronounced changes. Synovitis, mainly of a mild, localized type, was diagnosed in 39 joints (93%). More pronounced synovitis was found arthroscopically in 12 (31%). Adhesions were found in 20 joints (48%) and were significantly correlated with joints displaying osteoarthrosis (P < 0.001). The overall success rate for arthroscopic lysis and lavage was 50% (21/42 joints). The best response to lysis and lavage was in joints with arthroscopic diagnosis of pronounced synovitis (8/12 joints; 67%). All 21 joints regarded as unsuccessful were operated with diskectomy without implants. The success rate at 1-year follow-up was 18 joints (86%).

Adolescent↗
PubMed1994

Temporomandibular joint osteoarthrosis. Correlation of clinical and arthroscopic findings with degree of molar support.

The prevalence of temporomandibular joint (TMJ) osteoarthrosis and synovitis was compared in 60 patients with painful chronic locking of the TMJ. Thirty patients had reduced molar occlusion, and as controls, 30 age-matched fully dentate patients were examined. Assessment comprised clinical examination (crepitation), tomography (sclerosis and erosions), and arthroscopy (cartilage involvement) of the TMJ. Arthroscopic signs of osteoarthrosis and synovitis were frequent in both groups. The highest frequency of osteoarthrosis was diagnosed by arthroscopy. With regard to clinical signs and symptoms, tomographic signs of osteoarthrosis, and arthroscopic diagnoses, no statistical differences were found between fully dentate subjects and those with reduced molar occlusion. The results do not support the concept that prevention of TMJ osteoarthrosis is an indication for prosthetic replacement of lost molars.

Adult↗
PubMed1994

Metabolic turnover of sulfated glycosaminoglycans and proteoglycans in rabbit temporomandibular joint cartilages with experimentally induced osteoarthrosis.

Osteoarthrosis-like changes were induced by means of experimental disk perforation in the right temporomandibular joint of rabbits. The turnover of proteoglycans and glycosaminoglycans was studied 16 weeks later, using 35SO4. Tissues were sampled 1 day and 7 days after injection of the sulfate. The corresponding tissues from the left untreated joint were used as controls. After isolation of the glycosaminoglycans the incorporation of 35SO4 was estimated by scintillating counting. The extracted proteoglycans were analyzed, using gel electrophoresis, and the distribution of radioactivity was determined by autoradiography, followed by densitometry. Both the synthesis and rate of degradation of the proteoglycans were increased in the experimental disk, compared with those of the control. The net result of these metabolic changes seemed to be losses of small proteoglycans, whereas a slow increase in the number of larger ones may have occurred. The turnover rates of 4- and 6-sulfate increased, although their ratio remained unchanged at this stage of the osteoarthrosis-like process. In the condylar cartilage the turnover of large and small proteoglycans was also increased. The increase was most marked among those containing 6-sulfated galactosaminoglycans. The results concerning the experimental condylar cartilage indicated a decrease in the largest proteoglycan population, whereas the proportion of small proteoglycans was increased.

Animals↗
PubMed1992

Synovial chondromatosis of the temporomandibular joint. Report of a case.

A case of synovial chondromatosis of the temporomandibular joint is reported in which initial clinical and radiographic data indicated disk derangement. Magnetic resonance imaging revealed distention and thickening of the lateral capsule but could not delineate the numerous loose bodies found at arthrotomy. The literature is reviewed, and diagnosis and surgical therapy are discussed.

Arthroscopy↗
PubMed1992

Glycosaminoglycans in normal and osteoarthrotic human temporomandibular joint disks.

Glycosaminoglycans in normal and osteoarthrotic temporomandibular joint disks were studied by means of high-performance liquid chromatography methods. Normal disk tissue contains galactosaminoglycans (chondroitin sulfate and dermatan sulfate) as the main polysaccharides and with smaller amounts of hyaluronate and heparan sulfate. The galactosaminoglycans are mainly sulfated in 6-position, and some of the disaccharides contain iduronic acid. There was a slight general variation in glycosaminoglycan concentration with increasing age. In the severely arthrotic disks the content of glycosaminoglycans was considerably lower than in normal disk tissue. This decrease was far more extensive than that observed in relation to age in normal tissue. The 4/6-sulfate ratio of the galactosaminoglycans was increased, whereas the proportion of iduronic acid was markedly decreased.

Adolescent↗
PubMed1992

An experimental model of osteoarthrosis in the temporomandibular joint of the rabbit.

Degenerative changes in the temporomandibular joint were induced in 24 rabbits by surgical perforation of the disk. The incongruence obtained between the joint surfaces caused a gradual increase in macroscopic and microscopic changes, including gross remodeling, loss of tissue volume, and altered cell morphology within a 16-week observation period. These changes occurred concurrently with major alterations in the composition of the matrix, as demonstrated by increase in the glycosaminoglycan content of both condylar cartilage and disk and by loss of hydroxyproline in the disk. The lesions in the disk tissue were clearly discernible, whereas those in the condylar cartilage were less extensive. The described method is concluded to give alterations in the temporomandibular tissues, as seen in degenerative joint disease of an early stage.

Animals↗
PubMed1992

Diagnostic TMJ arthroscopy.

Temporomandibular joint arthroscopy has gained wide interest in recent literature. This article reviews the literature and describes equipment and techniques for diagnostic arthroscopy. Indications for diagnostic arthroscopy together with the possible intra- and postoperative complications are presented based on the authors own results. The diagnostic accuracy of temporomandibular joint arthroscopy is discussed.

Arthroscopy↗
PubMed1991

Apicectomy: a comparative clinical study of amalgam and glass ionomer cement as apical sealants.

Healing capacity after apicectomy was investigated in a randomized clinical study of 105 teeth apically sealed with either amalgam or glass ionomer cement. The results were evaluated clinically and radiographically after 1 year. The success rate was high for both materials: 91% for amalgam and 89% for glass ionomer cement. Contamination with moisture and blood adversely affected the outcome for both materials and was significantly more frequent in unsuccessful cases.

Apicoectomy↗
PubMed1991

Concentrations of neuropeptides substance P, neurokinin A, calcitonin gene-related peptide, neuropeptide Y and vasoactive intestinal polypeptide in synovial fluid of the human temporomandibular joint. A correlation with symptoms, signs and arthroscopic findings.

Arthroscopy was performed on 18 patients (19 joints) with temporomandibular joint arthropathy. Arthroscopic investigation revealed that 12 patients had disk derangement, including 3 patients with rheumatoid arthritis. Six patients had osteoarthrosis, including one patient with rheumatoid arthritis. Synovial fluid content of substance P-like immunoreactivity (SP-LI), neurokinin A (NKA-LI), calcitonin gene-related peptide (CGRP-LI), neuropeptide Y (NPY-LI) and vasoactive intestinal polypeptide (VIP-LI) were analysed using radioimmunoassay technique. All peptides analysed were found, although in various concentrations, in the different joints. There were no significant differences in concentrations of the peptides in the synovial fluid between patients in the various groups. No significant correlation was found between clinical symptoms and signs, arthroscopic findings, or use of analgesic/anti-inflammatory medication versus concentrations of peptides in the synovial fluid. In comparison with earlier findings in the knee joint significantly higher concentrations of SP-LI, CGRP-LI and NPY-LI were found in the TMJ.

Adult↗
PubMed1990

Diskectomy in treatment of disk derangement. A one and three year follow-up.

Diskectomy for treatment of temporomandibular joint disk derangements was evaluated clinically. The study comprised 40 consecutive patients (50 joints) with pain in the joint area and functional impairment not alleviated with nonsurgical therapy for at least 6 months. Diskectomy was performed in 32 joints. In 18 joints both diskectomy and minor arthroplasty were performed. No disk substituting implants were used. At 1 year follow-up 85% of the patients were free of symptoms from the temporomandibular joint area and showed normalized mandibular movements. Twenty patients were followed for 3 years. Two patients with arthrosis showed recurrence of symptoms. It was concluded that diskectomy is an effective surgical procedure for treatment of temporomandibular joint disk derangements.

Adult↗
PubMed1988

Arthroscopy of the temporomandibular joint. A comparative study of arthroscopic and tomographic findings.

Established radiographic criteria of temporomandibular joint osteoarthrosis were evaluated by comparison of arthroscopic and tomographic findings in the superior compartment. 34 joints of 30 patients with long-standing chronic pain and/or functional impairment were investigated according to standardized techniques. Agreement was found between arthroscopy and corrected sagittal tomography regarding diagnosis of osteoarthrosis in all advanced cases. Diagnostic accuracy as regards slight changes was, however, lower. At tomographic examination, the sensitivity was slightly higher than specificity, i.e., pathological changes were more frequently identified than normality. No radiographic sign of osteoarthrosis could be specifically associated with arthroscopic features of osteoarthrosis or synovitis. Predominant location of osteoarthrosis at both arthroscopy and tomography was the posterior slope of the eminence (latero-central part). Osteoarthrosis was more widespread in the fibrocartilage than in the subchondral bone.

Adult↗
PubMed1988

Arthroscopy of the temporomandibular joint: occurrence and location of osteoarthrosis and synovitis in a patient material.

The superior compartments of 42 temporomandibular joints of 38 patients with longstanding chronic pain and/or functional impairment were examined arthroscopically. Occurrence and location of osteoarthrosis and synovitis were investigated. Osteoarthrosis occurred in 31 joints (74%). In 17 of them more extensive changes were found. Predominant location of osteoarthrosis was the posterior slope of the eminence. The disk was less frequently affected and most commonly in the latero-central part. Synovitis occurred in 22 joints (52%) and was combined with osteoarthrosis in 17 of them. In 20 of them it was of mild and localised nature. The posterior disk attachment was affected in all of them.

Adult↗