Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model.

PURPOSE: Acute mesenteric ischaemia (AMI) is a life-threatening vascular emergency with a high mortality rate. Early diagnosis is the key to reducing its mortality rate and improving the quality of life. Although computed tomography (CT) is still the gold standard for acute intestinal disorders, over the last few years, magnetic resonance imaging (MRI) has become a useful alternative tool. An animal model of AMI was developed in order to study the effectiveness of MRI in early detection of this condition and to observe lesion evolution. METHODS: Thirty Sprague Dawley rats were randomly divided into two groups (n=15): in the first group, after laparotomy, the animals underwent ligation of the superior mesenteric artery (SMA), followed by macroscopic monitoring and histological evaluation; in the second, ischaemia was induced by squeezing a loop around the SMA 3 days before evaluation with 7-T micro-MRI. RESULTS: Macroscopically, a reflex spastic ileus followed by reflex hypotonic ileus and colour changes in some of the loops were detected. MRI evidenced luminal dilatation with air-fluid levels, free intraperitoneal fluid and bowelwall oedema. Histological analysis confirmed ischaemia and earlier damage involving the central portion of the ileum. CONCLUSIONS: This model shows the correct sequence of events during arterial AMI and demonstrates that MRI can be recommended for early diagnosis of these lesions.

Clinical value of 12 occlusal features for the prediction of disc displacement with reduction (RDC/TMD Axis I group IIa).

The purpose of this study is to quantify the clinical value of 12 occlusal variables for the prediction of disc displacement with reduction diagnosed according to research diagnostic criteria (RDC)/temporomandibular disorder (TMD). Twelve occlusal features were clinically assessed by the same three operators. The sample consisted of 165 TMD patients (65 males, 100 females; mean age: 32.55 +/-11.685 years) with only disc displacement with reduction (RDC/TMD Axis I group IIa) and a control sample of 145 healthy subjects (65 males, 80 females; mean age:31.24+/-12.436 years) diagnosed with RDC/TMD Axis I group 0. A stepwise multiple logistic regression model was used to identify the significant correlation between occlusal features and disease. The odds ratio for disc displacement was 2.84 for absence of canine guidance, 2.14 for mediotrusive interference and 1.75 for retruded contact position (RCP)/maximum intercuspation (MI) slide >or=2 mm. Other occlusal variables did not reveal to be statistically significant. The percentage of the total log likelihood for disc displacement explained by the significant occlusal factors was acceptable with a Nagelkerke's R(2) = 0.124. The final model including the significant occlusal features revealed an optimal discriminant capacity to predict patients with disc displacement with a sensitivity of 63.6% or with a specificity of 64.8% for healthy subjects and an accuracy of 64.2%. Occlusal features showed a low predictive value for detecting disc displacement. Multifactorial complex pathologies such as TMD should be investigated using a multivariate statistical analysis; moreover,the future of aetiopathogenic research in this matter requires a multifactorial approach.

Cortical regions supporting reading comprehension skill for single words and discourse.

A substantial amount of variation in reading comprehension skill is explained by listening comprehension skill, suggesting tight links between printed and spoken discourse processing. In addition, both word level (e.g., vocabulary) and discourse-level sub-skills (e.g., inference-making) support overall comprehension. However, while these contributions to variation in comprehension skill have been well-studied behaviorally, the underlying neurobiological basis of these relationships is less well understood. In order to examine the neural bases of individual differences in reading comprehension as a function of input modality and processing level, we examined functional neural activation to both spoken and printed single words and passages in adolescents with a range of comprehension skill. Data driven Partial Least Squares Correlation (PLSC) analyses revealed that comprehension skill was positively related to activation in a number of regions associated with discourse comprehension and negatively related to activation in regions associated with executive function and memory across processing levels and input modalities.

Coronoid hyperplasia. A case report.

Coronoid hyperplasia is a rare condition which is macroscopically characterized by an increase in the dimensions of the coronoid process resulting from an abnormal bony elongation of histologically normal bone. Unilateral cases are more frequent than bilateral ones and can recognize a number of etiological factors, such as exostoses, osteochondroma, traumatic events, inflammatory reactions, neoplasia and manifestations secondary to other pathologies. Etiopathogenesis of bilateral forms has not yet been clarified: in the literature hints to both developmental and endocrine abnormalities are present, and a familiar pattern of inheritance has been evidenced. The poor specificity of signs and symptoms associated with coronoid hyperplasia, which are similar to those of other more frequent forms of temporomandibular disorders, present some problems of differential diagnosis. An accurate assessment must be based on a clinical and anamnestical approach aiming at the identification of pathognomonic clinical symptoms. Considering its limits (such as the possible presence of artefacts and image distortions), orthopantomography has a poor diagnostic usefulness. In this case, magnetic resonance (MR) allowed to evaluate disk-condyle relationship, but it could be also useful to evaluate post-operative complications. In the case of coronoid hyperplasia, the computed tomography (CT) is fundamental for a correct differential diagnosis. CT also allows surgical planning due to its accuracy to detect coronoid process volume and morphology. The present case report is an example of the need for a correct differential diagnosis between the different types of temporomandibular disorders, and it also lends support to the importance of requesting modern imaging techniques during the diagnostic process of the rare or complex cases.

The 5-year clinical course of high-functioning men with DSM-IV alcohol abuse or dependence.

OBJECTIVE: One goal of diagnostic criteria is to predict the course of clinically relevant future problems. This study evaluated the ability of the DSM-IV categories of alcohol abuse and alcohol dependence to predict the onset and cessation of the 11 DSM-IV abuse/dependence criterion items. METHOD: The DSM-IV categorical approach was used to determine alcohol diagnoses for 435 highly educated young adult men, who constituted 97.3% of the 447 men appropriate for this study. Structured face-to-face follow-up interviews were administered 5 years later. RESULTS: At the beginning of the study, 14.5% (N=63) of the subjects were alcohol dependent, 18.2% (N=79) reported alcohol abuse, and 67.4% (N=293) carried no alcohol diagnosis. Across these three diagnostic groups, 68.3%, 46.8%, and 15.4%, respectively, experienced at least one of the 11 DSM-IV abuse/dependence criterion items over the next 5 years. Only 11.4% of those who reported alcohol abuse went on to develop alcohol dependence. In addition to their diagnosis, characteristics that predicted subsequent problems with alcohol included a family history of alcoholism, higher levels of alcohol intake and a greater number of alcohol problems in the 10 years preceding the diagnosis, and a history of drug use. CONCLUSIONS: Even in this highly educated and high-functioning group of men, alcohol abuse and dependence predicted the onset and cessation of alcohol-related problems.

Sarcoplasmic reticulum Ca2+-ATPase and acylphosphatase activities in muscle biopsies from patients with Duchenne muscular dystrophy.

Sarcoplasmic reticulum Ca2+-ATPase, acylphosphatase and other soluble enzymes (creatine kinase, lactate dehydrogenase, aldolase and pyruvate kinase) were assayed in muscle biopsies from patients affected by Duchenne muscular dystrophy (DMD) and from normal controls. Specific activities of all the soluble enzymes were decreased in dystrophic muscle, acylphosphatase exhibiting the most marked and significant decrease comparable to that of creatine kinase, in spite of a moderate increase in serum levels. Also, Ca2+-ATPase, particularly the calcium-dependent activity, was decreased in dystrophic muscle. A positive correlation, higher than with the other soluble enzymes, was obtained between acylphosphatase specific activity and the percentage of Ca2+-activation of Ca2+-ATPase. These findings: suggest an impairment of microsomal calcium uptake which could be, at least in part, responsible for sarcoplasmic calcium accumulation observed in DMD; do not disagree with an hypothesized role of acylphosphatase in intracellular calcium homeostasis, consistent with the enzyme's demonstrated hydrolytic activity on the phosphorylated intermediate of Ca2+-ATPase.

Horse heart acylphosphatase: purification and characterization.

The use of an affinity chromatography step performed with an immunoadsorbent consisting of anti-horse muscle acylphosphatase antibodies covalently linked to Sepharose 4B allowed us to purify horse heart acylphosphatase in a very rapid and efficient fashion. As in skeletal muscle, also in heart the enzyme is present as both a mixed disulfide with glutathione and a S-S dimer. The abundance of these forms in heart is quite lower than in skeletal muscle. The comparison of the molecular forms so purified with those obtained from horse skeletal muscle showed the same aminoacid composition, tryptic fingerprint, together with strictly similar apparent molecular weight and main kinetic parameters, supporting the conclusion that the acylphosphatase present in heart is the same enzyme as that purified from skeletal muscle.

Psychic and occlusal factors in bruxers.

BACKGROUND: The aim of this study was to investigate the existence of associations between bruxism and psychic and occlusal factors. METHODS: Participants in this study (n=85) were recruited from the Section of Odontostomatology, Deparent of Neuroscience, University of Pisa, Italy. They were split into two groups, bruxers (n=34) and non-bruxers (n=51), on the basis of the presence of both clinical and anamnestical indicators of bruxim. All participants were administered two self-reported validated questionnaires to evaluate (MOODS-SR) and panic-agoraphobic (PAS-SR) spetra. A number of occlusal variables (deep-bite: cross-bite, open-bite, mediotrusive and laterotrusive interferences, slide RCP-ICP, laterotrutsive guides, canine and molar classes) were also recorded. RESULTS: With regards to occlusal factors, the only association was revealed between bruxism mediotrusive interferences (p < 0.05). As for psychiatric investigation, significant differences between bruxers and controls emerged for the presence of both depressive (p < 0.01) and manic symptoms (p < 0.01) in MOODS-SR, and for stress sensitivity (p < 0.01), anxious expectation (p < 0.05), and reassurance sensitivity symptoms (p < 0.05) in PAS-SR. In particular, both mood (p < 0.01) and panic-agoraphobic (p < 0.05) spectra symptoms seem to differentiate bruxers from controls in males, while in females strong differences emerged for stress sensitivity symptoms (p < 0.05). CONCLUSIONS: It can be confirmed that certain psychic traits are present in bruxers, while occlusal factors are not useful parameters to discern bruxers from non-bruxers.

Etiopathogenesis of parafunctional habits of the stomatognathic system.

A broad consensus does exist among main authors on the importance of parafunctional habits in the etiopathogenesis of temporomandibular disorders (TMD). Mechanisms through which an intense parafunctional activity determined a pathological effect on the temporomandibular joints (TMJs) and their related structures have still not been definitively clarified; nevertheless, before investigating those mechanisms, it's useful to study predisposing, triggering and/or worsening factors of parafunctions themselves. At present the theory, once widely accepted, according to which occlusal interferences can trigger a muscular hyperactivity through the activation of periodontal receptors, has lost a lot of credit. Recently, the hypothesis that bruxism and other parafunctions have a central etiology has become more and more accepted. In such a context, the role of the psychic component assumes a strong relevance, particularly for its relation with the limbic system, which is the part of the central nervous system (CNS) that regulates emotions. Such a hypothesis is confirmed by clinical practice, but it doesn't explain why some patients have reported a worsening of parafunctional activities after occlusal adjustment. The aim of this study is to investigate this issue through a critical review of the literature, indicating how the 2 theories might be complementary for the development and worsening of a parafunctional habit. From this review, despite the number of clinical opinions, there emerges a lack of methodologically appropriate associative works and controlled clinical trials which consent to clarify the effective importance of psychic and/or occlusal factors in the etiopathogenesis of parafunctional habits.

17-beta-estradiol and progesterone serum levels in temporomandibular disorder patients.

AIM: Considering the hypothesis that some temporomandibular joint (TMJ) tissues could be a potential target for sexual hormones, the aim of the study was to evaluate estrogen (17-beta-estradiol) and progesterone serum levels in a young adult population affected by articular forms of temporomandibular disorders (TMD) versus a control group of healthy subjects. METHODS: A total of 35 patients with Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I Group II diagnosis of disk displacement and/or Group III diagnosis of arthralgia, osteoarthritis or osteoarthrosis, were recruited at the Section of Prosthetic Dentistry, Department of Neurosciences, University of Pisa, Italy, along with a sex- and age-matched group of 24 healthy controls. In all patients, 17-beta-estradiol, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) serum levels were determined using a radioimmunoassay. A T-test was performed to compare mean 17-beta-estradiol and progesterone serum levels in the TMD groups with mean serum levels of their respective control groups. Significance was set at p<0.05. RESULTS: Significant differences between patients affected by TMJ disorders and healthy controls were found for serum concentration of 17-beta-estradiol, both in males (p<001) and in the luteal phase of the menstrual cycle in females (p<0.05). No difference was found for progesterone serum levels in the different experimental samples. CONCLUSIONS: The results of this study suggest that high serum estrogens levels might be implicated in the physiopathology of temporomandibular joint disorders, since subjects with these pathologies showed significantly higher serum levels with respect to a group of healthy controls.

Occlusal features are not a reliable predictor of bruxism.

AIM: The aim of this investigation was to estimate the contribution of occlusion to differentiate bruxers from non-bruxers. METHODS: Participants in the study were 160 patients consecutively selected among 20-30 year old patients attending the Section of Prosthetic Dentistry for conservative care. The presence of bruxism was clinically and anamnestically investigated. In each patient the following occlusal features were recorded: retruded contact position-intercuspal position slide length, vertical overlap, horizontal overlap, unilateral posterior crossbite, incisor dental midline discrepancy, mediotrusive interferences, laterotrusive interferences. A stepwise logistic regression model was used to identify the significant associations between occlusal features and bruxism. RESULTS: Diagnosis of bruxism was made in 67/160 subjects (41.8%). Differences between sex were not significant (p=0.814). Among the 8 occlusal variables included in the logistic regression analysis, those remaining in the final model were laterotrusive interferences (OR 2.47) and anterior open-bite (OR 0.88). This model showed good specificity (87%) but an unacceptable sensitivity (26.9%) to predict bruxism (accuracy=61.6%). Therefore, multivariate analysis did not lead to an improvement in bruxism predictability with respect to univariate analysis, which revealed that the presence of bruxism was significantly associated with laterotrusive interferences alone (p=0.040), and not with unilateral cross-bite (p=0.208), anterior open-bite (p=0.202), deep-bite (p=0.572), large horizontal overlap (p=0.261), dental midline discrepancy (p=0.519), mediotrusive interferences (p=0.119), slide >or=2 mm (p=0.857). CONCLUSION: According to our findings the contribution of occlusion to differentiate bruxers from non-bruxers is very poor. Infact, only laterotrusive interferences seem to be significantly associated with bruxism.

Muscle relaxants in the treatment of myofascial face pain. A literature review.

Among the different pharmacological approaches that could be adopted in the treatment of myofascial pain of masticatory muscles, attention has to be paid to muscle relaxants drugs, since very few studies evaluated their efficacy, despite most authors suggest their use. The present paper is a critical review of the literature on the use of the most common drugs with muscle relaxant effects (benzodiazepines, tricyclic antidepressants) and of a muscle relaxant drug (tizanidine hydrochloride) in the treatment of such condition. From literature data it emerged that these drugs had phases of alternate enthusiasm, characterized by a not constant clinical use and a fair interest in research. Nevertheless, within all the limitations that have been discussed in this paper, the use of muscle relaxants in patients with myofascial pain of masticatory muscles seems to be justifiable, even though further research is needed to verify their usefulness in terms of risk-benefit ratio.

A critical review on the importance of psychological factors in temporomandibular disorders.

Recent researches on temporomandibular disorders (TMD) have been focused on the interaction between physical and psychological factors. In this work, studies on the role of the latter have been critically reviewed and analysed. A number of works proved the existence of an association between TMD and anxiety, depression and stress, but none demonstrated causality of that relation. In consideration of that, debates are still open to discuss the possible predisposing, triggering and/or worsening role played by some psychic disorders in TMD subjects. Nevertheless, considering the usefulness of recent taxonomic proposals, it seems logical to adopt a broad therapeutic approach, directed both to the physical and psychic component of TMD symptoms. Besides, from this review it is underlined the need for controlled trials which, regardless of the causality of TMD-psychic disorders associations, definitively evaluate the efficacy of the various psychotherapy modalities proposed.

[Ultrasonographic changes in the abdominal organs in the 10th decade of life]. / Alterazioni ultrasonografiche degli organi addominali nel decimo decennio di vita.

10 patients in perfect health, aged between 90 and 101 (mean age: 93 +/- 3), have been studied with echography in order to investigate the possible changes in volume and echo-pattern of abdominal organs, linked to the "physiological" aging. Our resulting data (reduced volume of liver and kidneys, changes in echo-pattern of pancreatic parenchyma, reduced thickness of renal cortical-medullary) seem to confirm the well known data of an atrophic change interesting the parenchyma of abdominal organs in aging: this latter, however, remains compatible with function preservation.

Anxiety symptoms in clinically diagnosed bruxers.

The present work was an attempt to investigate for the existence of an association between anxiety psychopathology and bruxism. The presence of bruxism was investigated according to validated clinical criteria in 98 subjects, who also filled out a self-report questionnaire (PAS-SR) for the assessment of panic-agoraphobic spectrum. 34.7% (n = 34) of participants were diagnosed as bruxers. The prevalence of anxiety psychopathology was similar between bruxers and non-bruxers, but Mann-Whitney U-test revealed significant differences in total PAS-SR (P = 0.026) score, indicating that subclinical symptoms of the anxiety spectrum might differentiate bruxers from controls. In particular, significant differences emerged in scores of domains evaluating panic (P = 0.039), stress sensitivity (P = 0.006) and reassurance sensitivity symptoms (P = 0.005) of panic-agoraphobic spectrum. Support to the existence of an association between bruxism and certain psychopathological symptoms has been provided.

Early interception of skeletal-dental factors predisposing to temporomandibular disorders during child development.

Temporomandibular disorders (TMD) comprise a heterogoneous group of pathologies or dysfunctions of the temporomandibular joints and their related neuromuscular systems. The multifactoral etiology of these disorders raises serious diagnostic and therapeutic problems. A modern approach demands close collaboration between a number of specialists in order to create the best possible treatment plan. The progressive nature of certain forms of TMD, combined with the major advantages deriving from early treatment, encourage the dental surgeon to carry out early interception of all those dental and/or skeletal anomalies which may determine the dysharmonic function and development of the facial mass, even though such anomalies may not represent the sole causes of the various forms of TMD. The general practitioner, and to an even greater extent the pediatrician, may therefore play a role of primary importance as those medical influences capable of early detection of TMD risk situations.

Acylphosphatase from human skeletal muscle: purification, some properties and levels in normal and myopathic muscles.

Human skeletal muscle acylphosphatase was purified by immunoaffinity chromatography using anti-horse muscle acylphosphatase antibodies. The three forms of the enzyme present in human muscle are very similar to those found in muscles of other animal species. The two main forms, Hu 1 and Hu 3, were also characterized with respect to molecular weight and some kinetic properties. Levels of acylphosphatase activity were measured in specimens of muscle from normals and from patients with various forms of muscular dystrophies and other myopathies. Acylphosphatase activity appears to be lower in all myopathic forms considered than in controls, and seems to be correlated with percentage of Ca2+ activation of (Ca2+ + Mg2+)-ATPase.

Clinical correlates of cigarette smoking and nicotine dependence in alcohol-dependent men and women. The Collaborative Study Group on the Genetics of Alcoholism.

This paper examines the clinical characteristics associated with tobacco use and nicotine dependence in a large sample of alcohol-dependent subjects. The goal was to determine if the characteristics of the alcohol use history were associated with the smoking status, even after controlling for additional characteristics, such as the antisocial personality disorder, other drug dependence and gender. As part of the Collaborative Study on the Genetics of Alcoholism, a semi-structured interview, including a detailed history of alcohol and tobacco use, was administered to 1005 alcohol-dependent men and women, made up of 658 (65.5%) current smokers, 167 (16.6%) former smokers, and 180 (17.9%) non-smokers. Among former smokers, 50.3%, and among current smokers, 72.8% had ever been nicotine-dependent (DSM-III-R). Current smokers and nicotine-dependent subjects had a greater severity of alcohol dependence, even as evaluated through logistic regression analyses in which gender and associated diagnoses were considered. The data also enabled us to study the relationships among depression, nicotine dependence, and alcohol dependence, with most of the correlation occurring for substance-induced, not independent, mood disorders.