To determine the value of MRI in temporomandibular joint (TMJ) disorders, the data of MRI-proven anterior disc dislocation without reduction (ADWOR) were correlated with clinical history and clinical data. MRI demonstrated degenerative bony changes and a reduced sagittal diameter of the condyle, a variable degree of disc deformation, and a thinned bilaminar zone in each of the joints with ADWOR, which clearly differed from patients with anterior disc dislocation with reduction (ADWR) (P = .01) and normal disc position (NDP) (P < .001). Of 59 patients and 83 TMJs that had been investigated in a 2-year period, as shown by MRI, 22 patients (27 TMJs) had ADWOR (32%), 16 joints had NDP (19%), and 40 patients had ADWR (49%). In patients with ADWOR, the clinical history revealed pain in either of the joints and/or cervical or masticatory muscles in 25 (93%) joints. Clinical investigation revealed various abnormalities in 22 joints; five of those presented without any pathologic clinical finding. Mouth opening was unlimited in nine patients (47%), palpation of the muscles of mastication was painless in 13 patients (52%), and joint noises during mouth opening or closing were noted in 14 patients (56%). According to clinical histories, four patients were suspected to have become symptomatic only after dental treatment. ADWOR is difficult to diagnose with clinical methods alone. The indication for MRI evaluation of the TMJ should be extended for asymptomatic patients with a history of limitation in mouth opening and pathologic x-ray morphology of the condyle. Because symptoms may arise after dental treatment in these patients, aggravation of internal derangement may be avoided by careful handling.

Adult↗

PubMedDate not supplied

Transrenal ureteral occlusion: results and problems.

PURPOSE: The effectiveness of transrenal ureteral occlusion was evaluated. PATIENTS AND METHODS: Transrenal ureteral occlusions were performed in 83 ureters of 76 patients. Thirty-one ureters were occluded with use of tissue adhesive, which was secured in place with Gianturco coils in 21. Fifty-two ureters were occluded by means of silicone-filled, detachable latex balloons. Average follow-up was 3.6 months (range, 1 week to 38 months) for patients treated with the tissue adhesive and 7.9 months (range, 1 week to 61 months) for patients treated with the detachable balloons. RESULTS: Seventeen (55%) of the 31 ureters occluded with tissue adhesive and 36 (69%) of the 52 ureters occluded with detachable balloons were permanently sealed after a single procedure. In 30 ureters, the occlusion procedure had to be repeated. The average duration of temporarily effective occlusions was 2.5 weeks when tissue adhesive was used and 19.5 weeks with detachable balloons. Complications were observed in 10 (7%) of 138 interventions. Only four of these were considered significant: two perforations occurred at the ureteropelvic junction, septicemia was seen after one procedure, and damage to a small intrarenal artery necessitated selective embolization in one patient. CONCLUSIONS: In selected patients, transrenal ureteral occlusion can effectively and safely interrupt urinary flow toward the bladder. Detachable balloons were superior to tissue adhesive as an occluding agent.

Aged↗

PubMedDate not supplied

[Percutaneous catheter extraction of a ruptured Port-A-Cath in a small child].

A male child with protein-losing enteropathy received the completely implanted venous access catheter "Port-A-Cath" (Pharmacia Co.) at the age of 13 months for the regular application of human albumine infusions. After 12 months of impeccable functioning the catheter ruptured. By means of a percutaneous transfemoral angiographic extraction the catheter fragment was removed from the right ventricle.

Catheterization, Central Venous↗

PubMedDate not supplied

Prostaglandin E2 and F2 alpha levels in human dental cyst fluid as bone resorbing factors?

Prostaglandin E2 and F2 alpha concentrations in aspirated cyst fluid of 14 human dental cysts were measured by radioimmunoassay. The mean concentrations were found to be 22.0 ng PGE2/g cyst fluid and 4.0 ng PGF2 alpha/g cyst fluid. As compared to plasma conditions a remarkable shift of the ratio of the two prostaglandins to PGE2 could be demonstrated. Due to the high concentrations of PGE2 found in the cyst material it is suggested that this prostaglandin may be one of the bone resorbing factors to be responsible for the destruction of bone in periodontal diseases.

Bone Resorption↗

PubMedDate not supplied

[Mechanochemistry of the joint cartilage and arthrosis--a pathophysiologic correlation].

The influence of changes in physicochemical parameters on the biomechanics of articular cartilage is investigated using relaxation tests in healthy rabbit cartilage. A mathematical model is established. An increase in ionic strength and osmolarity, as well as a rise in temperature lead to an increase in the compliance of cartilage. The majority of these phenomena are nonlinear and in most cases so characteristic that they can be associated with particular molecular processes in the cartilage matrix. The experimental results allow an insight into the functioning of articular cartilage and put another pathogenetical factor of arthrosis up for discussion by demonstrating the lability of the ideal mechanical condition.

Animals↗

PubMedDate not supplied

[Special problems of physical therapy in the aged].

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Aged↗

PubMedDate not supplied

[Personality structure of chronic rheumatically ill females].

80 female patients were tested for personality differences by the Freiburg Personality Inventory and the Giessen Test Self Image. They were divided into four groups with 20 patients each, suffering from rheumatoid arthritis, ankylosing spondylitis, spondylosis and coxarthrosis. While RA patients did not significantly differ from AS patients, nor spondylosis patients from coxarthrosis patients, certain personality differences were detected between the patients with inflammatory and those with degenerative rheumatic diseases. These results, however, do not allow us to draw the conclusion that a "degenerative or inflammatory rheumatic personality" exists. Besides the Giessen Test Self Image the Giessen Test Self Ideal was also administered to all of the patients. In all four groups the desire for a better basic mood and less depression was prevailing. RA patients also wanted more "social resonance" and "predominance". AS patients wanted significantly less "control" and more "responsiveness". These components should be given special consideration in the psychological care of rheumatic patients.

Arthritis, Rheumatoid↗