The orthodontic treatment of TMD patients: EMG effects of a functional appliance

The aim of this work was to test the effects of the Function Generator Bite (FGB) on the masticatory muscles of temporomandibular joint dysfunction (TMD) subjects. Two groups were selected for the study. A group of 20 TMD patients (group F) requiring orthodontic treatment and treated with FGB and a group of 10 healthy subjects (group H) were considered. Both groups were evaluated before the therapy began (TO) and then after 18 months of therapy (T1). An electromyographic analysis of the masseter and temporalis anterior muscles and a clinical evaluation according to the Research Diagnostic Criteria for TMD (RDC/TMD) were performed. A statistical difference between the two groups was observed at TO with respect to the activity index. TMD subjects showed a lower value of the index. Further studies are necessary to fully understand the utility of this EMG index as a diagnostic indicator.     

Combining nerve and tendon transfers in tetraplegia: a proposal of a new surgical strategy based on literature review

European Journal of Orthopaedic Surgery & Traumatology - Spinal cord injury (SCI) is very common, most frequently resulting from motor vehicle accidents and falling from a height. Often, SCI...     

Identification of domains of the HPV11 E1 protein required for DNA replication in vitro

The HPV E1 and E2 proteins along with cellular factors, are required for replication of the viral genome. In this study we show that in vitro synthesized HPV11 E1 can support DNA replication in a cell-free system and is able to cooperate with E2 to recruit the host polymerase alpha primase to the HPV origin in vitro. Deletion analysis revealed that the N-terminal 166 amino acids of E1, which encompass a nuclear localization signal and a cyclin E-binding motif, are dispensable for E1-dependent DNA replication and for recruitment of pol alpha primase to the origin in vitro. A shorter E1 protein lacking the N-terminal 190 amino acids supported cell-free DNA replication at less than 25% the efficiency of wild-type E1 and was active in the pol alpha primase recruitment assay. An even shorter E1 protein lacking a functional DNA-binding domain due to a truncation of the N-terminal 352 amino acids was inactive in both assays despite the fact that it retains the ability to associate with E2 or pol alpha primase in the absence of ori DNA. We provide additional functional evidence that E1 interacts with pol alpha primase through the p70 subunit of the complex by showing that p70 can be recruited to the HPV origin by E1 and E2 in vitro, that the domain of E1 (amino acids 353-649) that binds to pol alpha primase in vitro is the same as that needed for interaction with p70 in the yeast two-hybrid system, and that exogenously added p70 competes with the interaction between E1 and pol alpha primase and inhibits E1-dependent cell-free DNA replication. On the basis of these results and the observation that pol alpha primase competes with the interaction between E1 and E2 in solution, we propose that these three proteins assemble at the origin in a stepwise process during which E1, following its interaction with E2, must bind to DNA prior to interacting with pol alpha primase.     

Dislocation rate after hip arthroplasty within the first postoperative year: 36 mm versus 28 mm femoral heads

Dislocation is a common and important complication of total hip arthroplasty (THA). Larger femoral heads may reduce the risk of dislocation and improve the range of movement. The aim of this study was to compare the relative risk (RR) of dislocation during the first year after THA between implants with 28 mm and 36 mm femoral heads. 198 consecutive hips with 28 mm femoral head (Group-28) and 259 hips with 36 mm femoral head (Group-36) were studied. The patients were assessed preoperatively and periodically using the Harris hip score (HHS) and radiographic analysis. The relative risk (RR) of dislocation was calculated. The average HHS significantly improved from a preoperative baseline to the last follow-up at 82.1 months (28 mm) and 44.3 months (36 mm). No statistically significant differences were revealed between the two groups for HHS results and complications (p>0.05), but the difference in RR of dislocation within the first year between the two groups was 7.85 (95% CI: 1.34-46.03), p=0.046.Although dislocation is multifactorial in etiology, the two groups were homogenous for all principal contributing factors except the diameter of the femoral head. Therefore, the use of 36-mm heads can reduce the risk of dislocation following THA by a factor of 8 compared to conventional 28 mm heads.     

Primary inguinal hernia: The held-in mesh repair

Summary In the last 10 years, in Italy a rapid evolution has occurred from the “traditional” herniorraphies (Bassini, Shouldice) toward prosthetic techniques and outpatient procedures under local anesthesia are now most commonly preferred. Since october 1992 we have adopted a personal modification of the sutureless mesh repair, which we call held in mesh repair. Basic steps of this technique are: the placement of a plug in the deep ring for direct and indirect hernias; the linking of the medial edge of the prosthesis to the suture flattening the trasversalis fascia; the closure of the gap for the spermatic cord. With this technique 930 primary groin hernias were operated on in 798 patients (132 were bilateral); outpatient surgery was performed in 486 patients (60.9%). Anesthesia was local in 761 patients (95.4%). The mesh, generally sized 4.5×10 cm, in all cases was composed of polypropylene (Marlex^? or Prolene^?). 682 patients (85.5%) required analgesics. One hernia recurred (0.1%) after two years; one femoral pseudorelapse (0.1%) occurred at the 6th postoperative month. Nine complications occurred, for a rate of 0.9%. They were: one hemorrhage; 2 hematomas; one testicular atrophy; one lymphorrea; 2 ilioinguinal neuralgias; 2 seromas. No wound infections occurred; in none was it necessary to remove the mesh. The favorable results of the held in mesh repair and the simplicity of the procedure suggest that it can be considered a safe and reliable technique for most primary inguinal hernias. The negligible rates of femoral pseudorelapse and of indirect recurrences do not justify the employment in primary hernias of more complex preperitoneal techniques implying more complex anesthesia procedures and a higher C/B ratio.