Investigation on the construction of teaching case base in medical genetics.

Medical genetics is a basic medical course that discusses the diagnosis, prevention and treatment of diseases in relation with genetic factors. This course requires students who have abilities of strong logical thinking, independent thinking, problem analyzing and solving. Single "cramming" teaching is difficult to mobilize students' autonomous learning, and hardly achieves teaching effect of medical genetics. Teaching of case-based discussion breaks passive teaching mode in traditional class. The teacher throws out typically clinical cases. The students prepare materials around relevant problems of cases, and carry out class discussion. Then, key and difficult points of the course are integrated in teaching and learning interaction, which reaches a remarkable effect of teaching. Since 2013, the teaching and research group has carried out teaching of case-based discussion in undergraduates majoring in clinical medicine. In this paper, we screen and sort clinical cases on the basis of course teaching plan and case-based discussion in the teaching of medical genetics. The cases are summarized into 8 chapters in teaching case base, which basically cover the teaching of disease genetics and clinical genetics.The construction of teaching case base in medical genetics has realized the deep integration of clinical cases and teaching. Students can understand and master important and difficult points of teaching in a more intuitive way, which is helpful to stimulate students' innovative thinking, improve students' learning interest and class participation.

Research on Straightness Error Compensation of Grating Ruling Machine.

Echelle grating is a kind of special diffraction grating. Working with high diffraction orders and big diffraction angle, which has the advantages of high resolution and full wave shining. It has been widely used in high-end spectrum instrument, which greatly promoted the development of aerospace, astronomy, medical, military, environment and other cutting-edge technology. However, professional scoring system needs to be customized, and the price is very expensive. The use of sophisticated ultra precision machining equipment to process in the ladder grating can greatly reduce the preparation cost of the mother plate of the ladder grating. Due to the bad straightness and high accumulative error of ultra precision single point diamond lathe, it can't satisfy the demand of preparation when preparing the echelle grating, casuing the bad diffraction wave front. In order to reduce the straightness error, this paper comes up with the error compensation for the single point diamond lathe. Firstly, we make the first compensation based on the accumulative error curve. When the compensation ratio is 0.75 to 0.85, the peak valley value (pv) of the diffraction wave front is about 400 nm, reaching its greatest effect of the first straightness compensation. Secondly, we make the straightness compensation according to the diffraction wave front curve of the blazed order. The pv of the diffraction wave front is about 83nm. The results show that the diffraction wave front is greatly improved which is beneficial to improve the quality of the grating, and has a guiding role in the actual grating characterization.

Correlation between insulin-induced estrogen receptor methylation and atherosclerosis.

BACKGROUND: Hyperinsulinemia and insulin resistance have been recently recognized as an important cause of atherosclerosis. Clinical studies have also found that expression of the estrogen receptor is closely related to the incidence of atherosclerosis. This study investigate the effects of insulin and estrogen receptor α (ER-α) in atherosclerosis. METHODS: Double knockout ApoE/Lepr mice were given intraperitoneal injections of insulin, and their aortae were harvested for hematoxylin-eosin staining and immunohistochemical analysis. In addition, vascular smooth muscle cells (VSMCs) were treated with insulin or infected with a lentivirus encoding exogenous ER-α, and changes in gene expression were detected by real-time polymerase chain reaction and western blotting. The methylation levels of the ER-α gene were tested using bisulfite sequencing PCR, and flow cytometry and EdU assay were used to measure VSMCs proliferation. RESULTS: Our results showed that insulin can induce the formation of atherosclerosis. Gene expression analysis revealed that insulin promotes the expression of DNA methyltransferases and inhibits ER-α expression, while 5-aza-2'-deoxycytidine can inhibit this effect of insulin. Bisulfite sequencing PCR analysis showed that methylation of the ER-α second exon region increased in VSMCs treated with insulin. The results also showed that ER-α can inhibit VSMCs proliferation. CONCLUSIONS: Our data suggest that insulin promotes the expression of DNA methyltransferases, induces methylation of ER-α second exon region and decreases the expression of ER-α, thereby interfering with estrogen regulation of VSMCs proliferation, resulting in atherosclerosis.

Foreign body induced sialolithiasis treated by sialoendoscopic intervention.

OBJECTIVE: The study aims to identify the impact of sialolith formation by reviewing the foreign body induced sialolithiasis treated by sialoendoscopic intervention. METHODS: The study group included 13 patients whose sialolithiasis was induced by foreign body. After the routine radiographic examination, sialoendoscopic procedures were performed. Then, the treatment protocol was designed. RESULTS: The occupations of the 13 patients included 5 fishermen, 3 office workers, 2 workers, 1 teacher, 1 farmer, and 1 retired police officer. All patients had a unique diet habit-seafood. Eleven patients had a remembered incident of implanted fish bone and the following symptoms, with either obstructions or infections. Only 2 of the 13 had no memory of such an injury. All the stones were in the ducts of submandibular glands. In 10 procedures, there was 1 solitary stone, whereas 2 stones were encountered in 3 procedures. After being removed, 16 stones were crushed to expose the fish bone nidus of the stone. There was relief of symptoms after the procedures. CONCLUSIONS: This study supported the possibility that some sialoliths resulted from a retrograde migration within the salivary ducts. In our study, the occupations (fisherman), the diet habit (seafood), and the injury history (a remembered incident of implanted fish bone and the following symptoms) were obviously related to the stone formation that was induced by the fish bone.

Can puncture increase the risk of intra-articular adhesion in the temporomandibular joint?

PURPOSE: This study aims to compare the incidence and severity of intra-articular adhesion under arthroscopy between patients with and without a history of joint puncture. PATIENTS AND METHODS: Eighty-nine patients with internal derangements of TMJ who underwent arthroscopic disc repositioning and suturing surgery from February 2008 to September 2008 were included in this study. Patients were divided into 2 groups based on whether the patient had undergone joint puncture before surgery or not. The diagnosis of intra-articular adhesion was made according to the manifestation under arthroscopy. Incidence and severity of intra-articular adhesion between these 2 groups was compared. RESULTS: The incidence of intra-articular adhesion in the patients with a history of puncture was 69.23%, which was higher than that in the patients without a history of puncture (24.36%). The difference was statistically significant (P < 0.05). The incidence of severe adhesions in patients with a history of joint puncture was also higher than that in patients without a history of puncture (26.09% vs. 2.56%, P < 0.01). CONCLUSIONS: Puncture may increase the risk of intra-articular adhesion in patients with internal derangement.

Arthroscopic management for synovial chondromatosis of the temporomandibular joint: a retrospective review of 33 cases.

PURPOSE: To present clinical, radiologic, and arthroscopic results of patients with synovial chondromatosis of the temporomandibular joint; to introduce a technique for removal of loose bodies in different areas; and to summarize the indications of therapeutic arthroscopy according to the magnetic resonance imaging (MRI) features. PATIENTS AND METHODS: From April 2001 to April 2010, 33 consecutive patients underwent arthroscopy. Their demographics, clinical manifestations, imaging studies, arthroscopic findings, treatments, and outcomes were reviewed. RESULTS: The predominant symptoms were pain, limitation of mouth opening, and joint sounds. Obvious joint effusion was shown on MRI in 21 of 33 patients. Mass lesions were shown on MRI in 29 of 33 cases. The presence of loose bodies was shown in 31 cases under an arthroscope. Synovial hyperplasia was noted in 12 patients. Bony erosion of the articular surface was discovered in 11 patients. Thirty-two patients underwent therapeutic arthroscopy. Smaller loose bodies were commonly removed with joint lavage or biopsy forceps in 24 patients. Fragmentation with forceps or a wider additional incision was applied to remove larger loose bodies in 7 patients. Debridement was applied to remove intrasynovial lesions in 7 patients. Coblation was used to remove the hyperplastic synovium in 10 of 32 patients. Eight patients were lost to follow-up. The mean follow-up period was 38 months. No recurrence was suspected clinically and radiologically. CONCLUSIONS: Therapeutic arthroscopy was appropriate for patients with separate mass lesions and no extra-articular extension. Surgical treatment comprised thorough removal of loose bodies and affected synovial tissues.

A Novel Splicing Mutation c.335-1 G > A in the Cardiac Transcription Factor NKX2-5 Leads to Familial Atrial Septal Defect Through miR-19 and PYK2.

Mutations of NKX2-5 largely contribute to congenital heart diseases (CHDs), especially atrial septal defect (ASD). We identified a novel heterozygous splicing mutation c.335-1G > A in NKX2-5 gene in an ASD family via whole exome sequencing (WES) and linkage analysis. Utilizing the human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (hiPSC-CMs) as a disease model, we showed that haploinsufficiency of NKX2-5 contributed to aberrant orchestration of apoptosis and proliferation in ASD patient-derived hiPSC-CMs. RNA-seq profiling and dual-luciferase reporter assay revealed that NKX2-5 acts upstream of PYK2 via miR-19a and miR-19b (miR-19a/b) to regulate cardiomyocyte apoptosis. Meanwhile, miR-19a/b are also downstream mediators of NKX2-5 during cardiomyocyte proliferation. The novel splicing mutation c.335-1G > A in NKX2-5 and its potential pathogenic roles in ASD were demonstrated. Our work provides clues not only for deep understanding of NKX2-5 in cardia development, but also for better knowledge in the molecular mechanisms of CHDs.

Application of rapid prototyping for temporomandibular joint reconstruction.

PURPOSE: To introduce the preliminary application of rapid prototyping (RP) for temporomandibular joint (TMJ) surgery. MATERIALS AND METHODS: This study included 11 consecutive patients (13 joints) seeking TMJ replacement. All patients had previously undergone 3-dimensional computed tomography (CT) scanning (0.625-mm slice thickness) of the craniofacial skeleton. The data from CT scanning in DICOM (Digital Imaging and Communications in Medicine) format were input into the interactive Simplant CMF software program (Materialise Medical, Leuven, Belgium). Preoperative planning included segmentation and osteotomies. The movements of the jaw bones were simulated by use of Simplant CMF. The affected mandible was reconstructed based on the contralateral side. Then, the titanium plate was shaped on the reconstructed model before surgery. The bone graft was transplanted by the shaped titanium plate during the operation to reconstruct the TMJ. Twenty-four patients who underwent traditional surgery were used as the control group. The operative time of the 2 groups was analyzed with the SPSS software package, version 13.0 (SPSS, Chicago, IL), with the Student t test. The data from CT scanning in the experimental group before and after surgery were compared by paired t test. RESULTS: All the incisions healed primarily without any complications. All patients were satisfied with the operation, because of their symmetric faces and good occlusion. Postoperative magnetic resonance imaging confirmed the position of the transplanted costochondral cartilage in the glenoid fossa. A group t test showed that the operative time was longer in the control group (mean, 7.09 hours) than that in the RP group (mean, 5.67 hours). Three parameters (condyle-incisor, condyle-mental foramen, and condyle-angle) from the postoperative CT scan were analyzed by paired t test, and there was no significant difference between the 2 sides. CONCLUSION: RP technology provides an advanced method for TMJ reconstruction that can make the TMJ reconstruction more accurate and symmetric, improve the mandible's function, and consequently, enhance the reconstructive effect.

Malocclusion as a common occurrence in temporomandibular joint arthroscopic disc repositioning: outcomes at 49 days after surgery.

PURPOSE: To evaluate the incidence, clinical manifestation, and prognosis of malocclusion after arthroscopic disc repositioning and suturing of the temporomandibular joint (TMJ). PATIENTS AND METHODS: The study included 211 patients (270 joints) with internal derangement of the TMJ who underwent arthroscopic disc repositioning and suturing from November 2005 to August 2006. The occlusion was checked and recorded preoperatively and at different intervals (0, 3, 7, 14, 21, 28, 35, 42, and 49 days after surgery) for all patients. The incidence of malocclusion after surgery was determined for every follow-up period. The χ(2) test was applied to assess the statistical significance of the changes of the incidence of malocclusion. RESULTS: The incidences of malocclusion were 100%, 80.1%, 67.8%, 46.9%, 28.9%, 18.0%, 15.7%, 14.6%, and 14.2% at 0, 3, 7, 14, 21, 28, 35, 42, and 49 days after surgery, respectively. There was a significant difference between neighboring follow-up periods within 28 days after surgery, whereas there was no significant difference from 28 to 49 days after surgery (P > .05). The main clinical manifestations of malocclusion were posterior open bite on the surgery side, incisal prematurities, and mandible midline deviated or nondeviated. CONCLUSION: Malocclusion commonly occurs after TMJ arthroscopic disc repositioning and suturing. However, it will improve within 28 days after surgery in most patients. If malocclusion lasts over 28 days, appropriate treatments should be considered.

New arthroscopic disc repositioning and suturing technique for treating internal derangement of the temporomandibular joint: part II--magnetic resonance imaging evaluation.

PURPOSE: To evaluate the efficiency of an arthroscopic suturing technique for stabilizing anteriorly displaced discs in patients with internal derangement of the temporomandibular joint (TMJ) by magnetic resonance (MR) imaging. PATIENTS AND METHODS: Six hundred thirty-nine patients (764 joints) diagnosed as having stages II to V of internal derangement were treated with arthroscopic disc repositioning and suturing from August 2004 to March 2007. Consecutive MR images were used to evaluate internal derangement before and approximately 1 to 7 days after the operation for all 639 patients. The disc position of the TMJ was judged according to the success criteria, which included 3 different sagittal planes (lateral, central, and medial). Operative efficiency in those patients, whose discs of the TMJ were affirmed to be in a normal position in all 3 planes, was evaluated to be excellent. Those patients whose discs were in a normal position in 2 planes were evaluated to be good. The others were evaluated to be poor. Cases evaluated as excellent and good were considered success cases (if the disc is displaced only in 1 or 2 planes before operation, the efficiency of the operation would be evaluated as a success only if the whole disc was in normal position). RESULTS: Postoperative consecutive MR images for all 764 joints confirmed that 95.42% (729/764) of the joints were excellent, 3.14% (24/764) were good, and only 1.44% (11/764) were poor. Repeated arthroscopic surgery or open surgery was carried out for the joints that were evaluated as poor. CONCLUSION: This study indicates that the TMJ arthroscopic suturing technique is effective in repositioning the TMJ disc as confirmed by an MR imaging examination, but long-term follow-up is necessary.

A time series of land cover maps of South Asia from 2001 to 2015 generated using AVHRR GIMMS NDVI3g data.

In South Asia, key differences in annual land use and land cover (LULC) take place due to climate change, global warming, human activity, biodiversity, and hydrology. So, it is very important to get accurate land cover information for this region. An annual LULC map that covers a comprehensive period is a major dataset for climatologically study. While yearly worldwide maps of LULC are produced from Moderate Resolution Imaging Spectroradiometer (MODIS) dataset, in 2001, the first LULC map of MODIS is generated which restrictions the perspective climatologically analysis. This research work generated a time series of yearly LULC maps of South Asia from 2001 to 2015 by using random forest classification from AVHRR GIMMS NDVI3g data. The MODIS land cover product such as (MCD12Q1) was used as a reference data for the trained classifier. The result was validated by using time series of annual LULC maps, and the spatiotemporal dynamic of LULC maps was illustrated in the last 15 years from 2001 to 2015. The simplified sixteen class versions of our 15-year overall accuracy of a land cover map are 86.70%, and 1.23% higher than that of MODIS maps. The change detection indicated that, for the last 15 years, the class of closed shrublands, savannas, croplands, urban and built-up land, barren, and cropland per natural vegetation mosaics increase notably during the 2001 to 2015, and in contrast, the class of woody savannas, evergreen needleleaf forests, open shrublands, grasslands, mixed forests, permanent wetlands, permanent snow and ice, evergreen broadleaf forests, and water bodies decrease notably during 2001 to 2015. These yearly land cover maps will be an essential dataset for the upcoming climate study, where time series of LULC maps accessibility is restricted.

Association between the NBS1 E185Q polymorphism and cancer risk: a meta-analysis.

BACKGROUND: NBS1 is a key DNA repair protein in the homologous recombination repair pathway and a signal modifier in the intra-S phase checkpoint that plays important roles in maintaining genomic stability. The NBS1 8360G>C (Glu185Gln) is one of the most commonly studied polymorphisms of the gene for their association with risk of cancers, but the results are conflicting. METHODS: We performed a meta-analysis using 16 eligible case-control studies (including 17 data sets) with a total of 9,734 patients and 10,325 controls to summarize the data on the association between the NBS1 8360G>C (E185Q) polymorphism and cancer risk. RESULTS: Compared with the common 8360GG genotype, the carriers of variant genotypes (i.e., 8360 GC/CC) had a 1.06-fold elevated risk of cancer (95% CI = 1.00-1.12, P = 0.05) in a dominant genetic model as estimated in a fixed effect model. However, the association was not found in an additive genetic model (CC vs GG) (odds ratio, OR = 0.98, 95% CI = 0.85-1.13, P = 0.78) nor in a recessive genetic model (CC vs GC +GG) (OR = 0.94, 95% CI = 0.82-1.07, P = 0.36). The effect of the 8360G>C (E185Q) polymorphism was further evaluated in stratification analysis. It was demonstrated that the increased risk of cancer associated with 8360G>C variant genotypes was more pronounced in the Caucasians (OR = 1.07, 95% CI = 1.01-1.14, P = 0.03). CONCLUSION: Our meta-analysis suggests that the NBS1 E185Q variant genotypes (8360 GC/CC) might be associated with an increased risk of cancer, especially in Caucasians.

Intra-articular adhesions of the temporomandibular joint: Relation between arthroscopic findings and clinical symptoms.

BACKGROUND: Intra-articular adhesion (IA) is one of the important pathologic signs of intracapsular temporomandibular joint (TMJ) diseases, but this factor has been rarely described with respect to its arthroscopic characteristics and histology. The purpose of this study was to describe the incidence and distribution of IA in patients with internal derangement (ID) and to investigate the correlation between adhesions and the clinical symptoms of patients with ID of TMJ with closed-lock. METHODS: A retrospective analysis was conducted of 1822 TMJs with ID that were refractory to nonsurgical treatments and underwent arthroscopic surgery between May 2001 and June 2008 in our department. Clinical findings were assessed on the basis of mandibular range of motion, patients' age and locking duration at the initial visit. ID stages were judged according to the Wilkes and Bronstein classification based on clinical symptoms and pre-operative magnetic resonance imaging. 1506 patients (1822 joints) with ID were divided into an adhesion group (486 patients) and a non-adhesion group (1020 patients). The associations between the two groups with respect to interincisal opening, clicking duration, locking duration and patients' age were statistically analyzed using a t-test. RESULTS: Arthroscopy confirmed occurrences of adhesion in 28.76% of the joints (524 joints out of a total of 1822). Grade 1 adhesion was found in 68.89% of those cases; grade 2 in 20.61%; grade 3 in 4.58%; and grade 4 in 5.92%. The percentages of instances of adhesion in different stages were as follows: 13.89% of the joints in Stage II had adhesion, 25.47% in Stage III, 37.99% in Stage IV, and 40.37% in Stage V. There were statistically significant differences for patients' age (t = 10.41, P < 0.001), interincisal opening (t = 9.54, P < 0.001), paining duration (t = 3.66, P < 0.001) and locking duration (t = 3.89, P < 0.001) between the two groups, while no statistically significant difference was found for clicking duration (t = 1.08, P > 0.05). CONCLUSION: The arthroscopic findings confirmed that the incidence ratio of adhesion was high and occurred predominantly with older patients with longer locking duration and less interincisal opening. As the stage of ID increased, the adhesion grade rose.

Effect of Hypoxia on the Muscle Fiber Switching Signal Pathways CnA/NFATc1 and Myostatin in Mouse Myocytes.

This study investigated the effects of a CoCl2-simulated hypoxic environment on the muscle fiber switching signaling pathways calcineurin A/nuclear factor of activated T cells cytoplasmic 1 (CnA/NFATc1) and myostatin. In this study, C2C12 muscle cells were cultured in vitro under CoCl2-simulated chemical hypoxic conditions, the expression levels of CnA and myostatin were detected through qRT-PCR and Western blot analyses, and a positioning study of NFATc1 was carried out by immunofluorescence labeling. Results showed that CoCl2 treatment significantly increased the expression levels of CnA and myostatin. Moreover, the position of NFATc1 expression changed; actually, its expression in the nucleus considerably increased. Furthermore, CoCl2-induced hypoxia inhibited the differentiation of C2C12 cells and reduced the expression levels of many slow- and fast-twitch muscles marker genes, but immunofluorescence staining results showed that the proportion of MyHC I type muscle fiber increased after CoCl2 treatment. The hypoxic environment simulated by CoCl2 can activate the signaling pathways CnA/NFATc1 and myostatin and increases the proportion of MyHC I type muscle fibers.

Preparation and Application of a New Crosslinked Polyammonium as a Shale Inhibitor.

BACKGROUND: Despite the fact that a number of traditional shale inhibitors have been utilized widely in drilling operations, the same additive may be unfavorable for different drilling due to environmental protection requirements which limit scales of use. Hence, a series of polyammonium compounds was prepared from dimethylamine, epichlorohydrin, and melamine (DEM). METHODS: To concentrate our efforts, we used both standard and extra methods to investigate the inhibitive properties of a melamine crosslinking agent using mud balls immersion tests, linear expansion measurements, laser particle distribution measurements, thermogravimetric analysis, and scanning electron microscopy. RESULTS: The anti-swelling rate of DEM-8 reached up to 92.3% when its concentration reached 0.8%. DEM-8 has strong inhibitive capability to bentonite hydration swelling. DEM-8 can affect the bentonite particle size at a large scale. It may adsorb on the surface of clay through hydrogen bonds and electrostatic interaction by an anchoring effect and a hydrophobic effect. CONCLUSIONS: Compared with a blank solution, DEM-8 displays high inhibitive ability against the hydration and swelling of clay. The mud ball is more stable in DEM-8 solution and its swelling degree is very low compared with that of the control test. The inhibition mechanism of DEM-8 to shale can be deduced in that hydrogen bonding, ion exchange, and anchoring effect help to control the hydration and swelling.

[Comparison of the formation cross-sections of exciton in fluorescent and phosphorescent dyes].

In the present paper, polymer-based light-emitting diode employing N-vinylcarbazole (PVK) doped with dilute phosphorescent dye factris-(2-phenylpyridine) iridium [Ir(ppy)3] and fluorescent dye 4-(dicyanomethylene)-2-t-butyl-6-(1,1,7,7-tetramethyljulolidyl-9-enyl)-4H-pyran (DCJTB) as active layer was fabricated in order to compare the formation cross-sections of triplet exciton and singlet exciton. According to the changes in the electroluminescence (EL) spectrum and the relative intensity of photoluminescence (PL) spectrum, we deduce that the exciton formation cross-section of Ir(ppy)3 is larger than that of DCJTB.

[Studies on photoluminescence spectra of polyfluorene under modulation of electric field].

The photoluminescence of polyfluorene thin film modulated by an electric field are studied. The results show that the photoluminescence from polyfluorene film can obviously quenched by the extra electric field, which is attributed to the electric field-induced dissociation of photogeneration excitons. The dependence of the exciton dissociation rate constant on the intensity of electric filed is fitted. The average hopping distance of element charge is 0.68 nm in PFO. This volume is comparable with the reported results in Alq3 and polymers. The spectral dependence of the factor of EFIQP is given. The dissociation of hot-exciton is deduced, which influences on the spectral dependence of the EFIQP factor slightly.

Stability study of total temporomandibular joint replacement on sheep.

OBJECTIVE: To evaluate the stability of our custom-made prosthesis by establishing the model of sheep total temporomandibular joint (TMJ) replacement. METHODS: Six sheep were included in our study. Spiral computed tomography (CT) data of all sheep was obtained and transformed into 3-dimensional model by surgicase5.0 software preoperatively. Total TMJ prostheses were made based on the skull model. Ultra-high molecular weight polyethylene was used to make glenoid fossa lining, while titanium alloy to prefabricate mandibular retention handle and titanium plate over glenoid fossa. Cobalt-chromium-molybdenum alloy was also used to prefabricate the condyle. The right sides of all sheep, as the experimental group, were carried out total TMJ replacement, while the left sides were as the control group. The bone in both experimental and control side were excised after 3 and 6 months. Scanning electron microscope (SEM) was used to observe the interface between bone and prosthesis. Van Gieson staining and immunohistochemical staining (IHC) were used respectively to observe the interface of titanium screw and bone and the expression of alkaline phosphatase (ALP). RESULTS: SEM and Van Gieson staining showed that there was immature bone and osteoid formed in the interface of prosthesis and bone after 3 months. While after 6 months, there was osseointegration between them. IHC showed that the expression of ALP in the experimental side was much higher than in the control side after 3 months and its expression decreased after 6 months with no difference from the control side. CONCLUSION: The custom-made TMJ prosthesis which was designed and manufactured by ourselves has good stability after total TMJ replacement.

Arthroscopic management of septic arthritis of temporomandibular joint.

This article reports on 7 patients with septic arthritis of the temporomandibular joint (TMJ) who were managed with arthroscopy between 1998 and 2007. The common symptoms were trismus and pain. A series of imaging studies showed widening of joint space in 1 patient with plain film; MRI demonstrated increased joint effusion in 4 patients; accompanying cellulitis in adjacent tissues was discerned by CT in 2 patients. Under the arthroscope, a reddened and swollen synovial membrane was found in 2 patients who were in the acute stage, whereas strong adhesions, destruction of cartilage, and bony defects were discovered in other 5 patients in the chronic stage. Additionally, the disc was ruptured in 3 patients, and fibrosis was confirmed for 2 patients. Lavage, lysis of adhesion, and debridement of articular surface were common procedures for treatments. The average follow-up period was 57.4 months, and no recurrence was found. Arthroscopy has proven to be a useful method for management of septic arthritis of TMJ, especially for patients in the chronic stage.