Immunohistochemical localization of cyclooxygenase-1 and -2 in synovial tissues from patients with internal derangement or osteoarthritis of the temporomandibular joint.

This study examined the immunohistochemical expression and localization of cyclooxygenase-1 and -2 (COX-1 and COX-2) in synovial tissues from patients with internal derangement (ID) or osteoarthritis (OA) of the temporomandibular joint (TMJ). Synovial tissues from patients with condylar fractures of the mandible were studied as control. Synovial tissues from 13 TMJs of 10 patients with ID or OA and from 5 TMJs of 4 patients with fractures were examined for COX-1 and COX-2 expression by immunohistochemical staining using two monoclonal antibodies. In addition, whether the COX-2 expression grade correlated with the synovitis score and clinical findings was assessed. COX-2 was expressed in the synovial lining, infiltrating mononuclear cells, fibroblast-like cells, and blood vessels, including CD31-positive endothelial cells, in the synovium of patients with ID or OA. Expression levels of COX-1 in synovial lining cells and endothelial cells were similar in the specimens obtained from the patients with ID or OA and those obtained from the controls. The expression of COX-2 positively correlated with arthroscopic findings of synovitis (p = 0.55, P = 0.023) and with joint pain (p = 0.56, P = 0.021). These results suggest that up-regulation of COX-2 in synovium may play a part in the pathogenesis of synovitis in patients with ID or OA of the TMJ.

Fifteen-year statistics and observation of facial bone fracture.

During the past 15 years, we encountered 1051 facial fractures. The number of patients with facial fractures accounted for 0.76% of the over all outpatients at the ENT clinic of Osaka City University Hospital. There were 496 nasal bone fractures, 111 maxillary fractures, 167 zygomatic fractures, 122 mandibular fractures, and 130 orbital fractures. These types of fractures accounted for 47.2%, 10.6%, 15.9%, 11.6%, and 12.4% of the over or facial fractures, respectively. The ratio of men to women was nearly three to one, with 794 men and 257 women. Among nasal fractures, injury causes were ranked in the order of fighting, sports, and traffic accident. Among facial fractures, injury causes were ranked in the order of the traffic accident, fighting, and falling down.

[Exposure to blood during midwifery procedures--blood contact events to midwives occurred in a delivery room].

Midwives are often exposed to blood during delivery procedures. A study aimed at clarifying actual status of blood contact during midwifery procedures was performed. Observations in a delivery room were conducted to record blood contact events experienced by midwives from the time of episiotomy until 2 hour after expulsion of the placenta. All gloves used by midwives were collected and tested for holes. Blood contact was defined as any contact with blood of a parturition woman as recognized visually by an observer. During a one-month study period data was obtained from a total of 19 midwives (12 midwives and 7 student midwives) who assisted in 8 deliveries. All of the midwives wore gowns with long sleeves, gloves and caps but did not use eye protection or masks. None of the parturient women had Hepatitis B, Hepatitis C or acquired immunodeficiency syndrome. Deliveries caused widespread blood exposure to the midwives throughout the complete course. Protection from most of this exposure was provided by the gowns and gloves. However, direct blood contacts occurred to the fingers, hands or forearms in several midwives. These events were caused by partly because the midwives unintentionally performed procedures without gloves and partly because blood penetrated the gown and soaked to the skin. Direct blood contacts to the foot in two midwives and to the mouth in one also occurred. The overall perforation rate for gloves examined was 4 out of 154 (2.6%). Two gloves were broken during washing sharp instruments contaminated with blood, one was torn when wearing, and the remaining one appeared to have had a hole prior to use.(ABSTRACT TRUNCATED AT 250 WORDS)

Pregnancy-associated globulin in body fluids of pregnant women.

Pregnancy-associated globulin (PAG) in saliva, urine and amniotic fluid was investigated just before and after delivery by Ouchterlony's method and immunoelectrosyneresis. In saliva, the incidence was more than 60 percent; 12 out of 18 samples by immunoelectrosyneresis and 11 out of 18 by Ouchterlony's method. In urine, 8 (33 percent) and 6 (25 percent) out of 24 samples were positive by immunoelectrosyneresis and Ouchterlony's method, but 19 out of 21 samples (91 percent) were positive by immunoelectrosyneresis. Of 12 pregnant women in whom serum, saliva, urine and amniotic fluid were tested by immunoelectrosyneresis, four showed positive reaction in the above four samples and 11 in three samples except urine.

First case of surgical treatment of Farber's disease.

Farber's disease (Farber's lipogranulomatosis), which is inherited as an autosomal recessive trait, was first reported by Farber in 1952. We report a case of Farber's disease in a 12-year-old female. Her younger brother was affected with Farber's disease and died of it at 2 years of age. When she first presented, our patient's main clinical features were a shrill voice; subcutaneous nodules; contracture of the joints throughout the body; and granulomas of the oral cavity, the pharynx, and the upper and lower eyelids. Serial radiographs disclosed deformation of the joints throughout the body. Due to the granulomas in her oral cavity, she could take little food orally and therefore was malnourished. We performed a granulectomy under general anesthesia, and her difficulty with feeding and upper airway obstruction improved. There is no specific treatment for Farber's disease, and most patients reported have died by 2 years of age. This is the first reported patient with Farber's disease who has been surgically treated.