Tadahiko Iizuka

Bone morphogenetic protein-2 in temporomandibular joints with internal derangement

OBJECTIVEnThe purpose of this study was to analyze the expression of bone morphogenetic protein-2 (BMP-2) in patients with internal derangement of the temporomandibular joint.nnnSTUDY DESIGNnTwenty-one human temporomandibular joint samples (5 extirpated disks and 16 biopsy specimens of synovitis area from patients with internal derangement of the TMJ) and 2 control temporomandibular joint specimens (2 normal disks obtained by autopsy) were analyzed with specific antibodies through use of an immunohistochemical technique.nnnRESULTSnBMP-2 was predominantly localized in chondrocytes around the damaged areas of the articular disks. BMP-2 expression was also found in synovial cells and endothelial cells of blood vessels. Control specimens demonstrated BMP-2 staining in synovial lining cells and endothelial cells of blood vessels. However, the chondrocytes in the normal cartilage layers of the control specimens showed no staining.nnnCONCLUSIONSnThese findings suggest that BMP-2 may be involved in the pathogenesis of osteoarthritic changes or the repair process of temporomandibular joint internal derangement.

A case of malignant schwannoma of mandible in von Recklinghausen's disease.

von Recklinghausen病 (以下R病) あるいは神経線維腫症は常染色体遺伝性疾患で3000の出生に対して1人の発現頻度といわれている。カフェオーレ斑, 末梢中枢神経系の神経線維腫症および幼少時より生じる骨格異常が特徴とされる。神経線維腫症は軟組織由来の悪性腫瘍を合併することが知られている。頭頸部腫瘍のなかで軟組織肉腫の発生は少なく, 特に神経線維腫症に合併した悪性神経鞘腫の症例は極めてまれである。今回われわれは, R病の女児に合併した下顎悪性神経鞘腫の1例を経験したので報告する。患者は7歳女児で, 右側下顎部腫脹, 開閉口障害を主訴に紹介来院した。右側下顎枝に直径5cm大の弾性硬の腫瘤を認め, 生検の結果, 悪性神経鞘腫と診断された。外科的切除, 術中放射線照射の後, 化学療法施行されたが約10か月後に局所再発および肺転移を生じ, 初診より1年4か月後に死亡した。

Clinical study of internal derangement of the temporomandibular joint with closed lock. Second report: Correlation of the disk configuration at MR imaging with clinical parameters.

Fifty-three closed lock cases of internal derangement of the temporomandibular joint (TMJ) were studied on the correlation between disk configuration at MR imaging and nine clinical parameters composed of opening degree, age, clicking and locking duration, visual analogue scale of pain (VAS), pain score, jaw dysfunction score, life activity limited score, and TMJ X-ray photo findings. Disk configuration and degree of anterior disk displacement were assessed on MR imaging in closed mouth position: the antero-posterior length of disk and the distance from condyle to anterior and posterior portion of disk were measured, respectively. Results were obtained as follows;1. Duration of clicking and locking were not correlated with MR index except that there was a strong correlation between clicking duration and the distance from condyle to anterior portion of the disk at MR imaging.2. Opening degree was related to the disk deformity and the access of posterior portion of the disk to condyle.3. Disk configuration and degree of antrior disk displacemnt were not correlatd with TMJ pain, but jaw dysfunction was related to the disk deformity and the distance from posterior portion of the disk to condyle.4. TMJ X-ray photo findings were not correlated with clicking duration (below 3 years), locking duration (below 30 weeks), opening degree and disk configuration at MR imging.5. In evaluation of factors related to opening degree in 53 patients with closed lock by means of multiple regression analysis, age, locking and clicking duration, TMJ pain, life activiy limited score were more strongly correlated to opening degree than the others.