Biomedical subjects

M Hori

Publications and source records attributed to M Hori.

At least 289 records · Page 16Linked to original sources

PubMed1999

Focal hepatic lesion detection: comparison of four fat-suppressed T2-weighted MR imaging pulse sequences.

PURPOSE: To evaluate fat-suppressed T2-weighted magnetic resonance (MR) imaging with conventional spin-echo (SE), breath-hold fast SE, respiratory-triggered fast SE, and breath-hold multishot SE echo-planar sequences for the detection of focal hepatic lesions. MATERIALS AND METHODS: Fat-suppressed T2-weighted MR images obtained with the four sequences in 55 patients with 81 solid and 129 nonsolid lesions were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 440 liver segments were reviewed separately for solid and nonsolid lesions by three independent radiologists. Diagnostic accuracy was evaluated with receiver operating characteristic analysis. RESULTS: The mean lesion-to-liver contrast-to-noise ratio was highest on the multishot SE echo-planar images of both solid and nonsolid lesions. Fat-suppressed respiratory-triggered fast SE images had significantly better (P < .05) or comparative detectability of both solid and nonsolid lesions compared with the other types of images. Image quality was best on the respiratory-triggered fast SE images. CONCLUSION: Fat-suppressed respiratory-triggered fast SE imaging should replace fat-suppressed conventional SE imaging as a standard T2-weighted imaging examination in the detection of focal hepatic lesions.

Adipose Tissue↗

PubMed1999

Pancreatic CT imaging: effects of different injection rates and doses of contrast material.

PURPOSE: To assess the effects of the intravenous injection rate and dose of contrast material on pancreatic computed tomography (CT). MATERIALS AND METHODS: A total of 126 patients were divided at random into four groups with different injection rates and doses. Groups 1 and 2 underwent injection of 2 mL per kilogram of body weight of 300 mg of iodine per milliliter of contrast material, and groups 3 and 4 underwent injection of 1.5 mL/kg. The injection rate was 5 mL/sec for groups 1 and 3 and 3 mL/sec for groups 2 and 4. Single-level serial CT scanning was performed at the level of the pancreatic head, and the pancreatic enhancement value was calculated. RESULTS: The maximum pancreatic enhancement value was 99 HU +/- 18 (mean +/- SD) for group 1, 90 HU +/- 18 for group 2, 86 HU +/- 15 for group 3, and 74 HU +/- 13 for group 4. There were significant differences in the maximum pancreatic enhancement value between groups 1 and 2 (P = .045), between groups 3 and 4 (P = .001), between groups 1 and 3 (P = .016), and between groups 2 and 4 (P = .001). CONCLUSION: Both a higher dose and a faster injection rate increased the maximum pancreatic enhancement value.

Adult↗

PubMed1999

Lumped constant for deoxyglucose is decreased when myocardial glucose uptake is enhanced.

Quantification of myocardial glucose uptake by positron emission tomography with [18F]fluorodeoxyglucose (FDG) requires the "lumped constant" (LC), which corrects the difference of affinity between glucose and FDG to glucose transporters and phosphorylating system. Since LC was introduced, it has been considered to be constant. However, this has recently been questioned. To elucidate the constancy of LC by other than radioisotope techniques, the accumulation rate of sugar phosphates (d[SP]/dt) was measured in isolated, perfused rat hearts by 31P NMR spectroscopy with 2-deoxyglucose (DG). We postulate alpha as the affinity of DG to transporters and the phosphorylating system relative to that of glucose. Theoretically, alpha is equivalent to LC. We determined alpha by measuring d[SP]/dt at DG concentration ([DG]) = 10, 7, 5, and 3 mmol/l, keeping the total of glucose concentration ([glucose]) and [DG] to 10 mmol/l. When the glucose uptake was enhanced by insulin (10 mU/ml) or stunning, calculated alpha was reduced (insulin stimulated, 0.15; stunning, 0.19) compared with the control (0.59). These results indicate that LC can be evaluated by methods without radiolabeled tracers and is smaller when glucose uptake is augmented.

Animals↗

PubMed1999

Impairment of EDR by a long-term PDGF treatment in organ-cultured rabbit mesenteric artery.

Platelet-derived growth factor (PDGF) has been shown to act chronically on blood vessels to regulate not only proliferation but also vascular tone. These effects may be at least partly due to the chronic effect of PDGF on vascular endothelium. To evaluate this possibility, we examined the effects of PDGF on the endothelium-dependent relaxation (EDR) and total RNA for endothelial nitric oxide (NO) synthase (eNOS) using an organ culture system. In rabbit mesenteric arteries cultured in a serum-free medium for 1 wk, amplitude of the substance P-induced EDR did not change, whereas dependency of the EDR on NO (approximately 60.0% vs. 18.9%) and the total amounts of recoverable eNOS mRNA estimated by RT-PCR were increased compared with those in freshly isolated arteries. Culture with PDGF for 1 wk decreased the relaxant effect of substance P and ionomycin (P < 0.01 compared with the arteries without PDGF), NO production estimated by bioassay (P < 0.01), and eNOS mRNA level, whereas the sodium nitroprusside-induced relaxation did not change. These results suggest that PDGF has a chronic effect on vascular endothelium to decrease eNOS mRNA and NO production and to impair NO-dependent EDR.

Animals↗

PubMed1999

Glycoprotein IIb/IIIa antagonist FK633 could not prevent neointimal thickening in stent implantation model of canine coronary artery.

The platelet glycoprotein (GP) IIb/IIIa receptor antagonist appears to reduce the need for revascularization after coronary angioplasty. However, since the effect of GP IIb/IIIa receptor antagonist on the in-stent neointimal thickening has not been clarified, we examined it in the canine model. The beagle dogs were assigned to the control (n=7) or the GP IIb/IIIa receptor antagonist FK633 group (n=7). FK633 was administered by subcutaneous osmotic pumps (0.2 mg. kg-1. h-1) and an intravenous bolus injection (1 mg/kg) before stenting. A coil stent was implanted in the left circumflex coronary arteries. The platelet aggregation capability was significantly (<5%) and consistently reduced by FK633 except for the mild elevation (10% to 30%) on the next day of stenting. Hearts were excised 3 months after stent implantation. The area of intima and media and the area stenosis were obtained from the sections of the stented arteries. The area of intima and media and the area stenosis (1.3+/-0.2 mm2, 41.8+/-7.5% and 1.3+/-0.2 mm2, 33.9+/-6.7% in the FK633 and the control group, respectively) were not different between the groups. We conclude that, although GP IIb/IIIa antagonist FK633 prevented the platelet aggregation significantly and consistently, it could not prevent the neointimal thickening after stent implantation in canine coronary artery.

Animals↗

PubMed1999

Human osteoclast-like cells are formed from peripheral blood mononuclear cells in a coculture with SaOS-2 cells transfected with the parathyroid hormone (PTH)/PTH-related protein receptor gene.

Subclones of the human osteosarcoma cell line SaOS-2 were established by transfecting with an expression vector containing the human PTH/PTH-related protein (PTHrP) receptor, and their abilities to support osteoclast-like multinucleated cell (OCL) formation were examined in coculture with mouse or human hemopoietic cells. Of four subclones examined, SaOS-2/4 and SaOS-4/3 bound high levels of [125I]-PTH and produced a significant amount of cAMP in response to PTH. OCLs were formed in response to PTH in the cocultures of mouse bone marrow cells with either SaOS-2/4 cells or SaOS-4/3 cells. Human OCLs were also formed in response to PTH in the coculture of SaOS-4/3 cells and human peripheral blood mononuclear cells. Adding dexamethasone together with PTH greatly enhanced PTH-induced human OCL formation. Like mouse OCLs, human OCLs formed in response to PTH were tartrate-resistant acid phosphatase positive, expressed abundant calcitonin receptors and vitronectin receptors, and formed resorption pits on dentine slices. Other osteotropic factors such as 1alpha,25-dihydroxyvitamin D3, prostaglandin E2, and interleukin 6 plus soluble interleukin 6 receptors failed to induce mouse and human OCLs in cocultures with SaOS-4/3 cells. Both mouse and human OCL formation supported by SaOS-4/3 cells were inhibited by either adding an antibody against macrophage-colony stimulating factor or adding granulocyte/macrophage-colony stimulating factor. Thus, it is likely that human and mouse OCL formation supported by SaOS-4/3 cells are similarly regulated. These results indicate that the target cells of PTH for inducing osteoclast formation are osteoblast/stromal cells but not osteoclast progenitor cells in the coculture. This coculture model will be useful for investigating the abnormalities ofosteoclast differentiation and function in human metabolic bone diseases.

Acid Phosphatase↗

PubMed1999

Futalosine and its derivatives, new nucleoside analogs.

Futalosine, a new nucleoside analog, was isolated from a fermentation broth of Streptomyces sp. MK359-NF1. Some chemical derivatives of futalosine were prepared. 6-O-Methylfutalosine methylester inhibited growth of HeLa-S3 cells in vitro (IC50 = 19.5 micrograms/ml) in contrast to the weak activity of futalosine. 6-O-Methylfutalosine methylester at concentrations higher than 10 micrograms/ml inhibited incorporation of 3H-TdR and 3H-UR but not 3H-Leu in the acid-soluble fractions of HeLa-S3 cells.

Antibiotics, Antineoplastic↗

PubMed1999

Adenosine and cardioprotection in the diseased heart.

Biological and mechanical stressors such as ischemia, hypoxia, cellular ATP depletion, Ca2+ overload, free radicals, pressure and volume overload, catecholamines, cytokines, and renin-angiotensin may independently cause reversible and/or irreversible cardiac dysfunction. As a defense against these forms of stress, several endogenous self-protective mechanisms are exerted to avoid cellular injury. Adenosine, a degradative substance of ATP, may act as an endogenous cardioprotective substance in pathophysiological conditions of the heart, such as myocardial ischemia and chronic heart failure. For example, when brief periods of myocardial ischemia precede sustained ischemia, infarct size is markedly limited, a phenomenon known as ischemic preconditioning. We found that ischemic preconditioning activates the enzyme responsible for adenosine release, ie, ecto-5'-nucleotidase. Furthermore, the inhibitor of ecto-5'-nucleotidase reduced the infarct size-limiting effect of ischemic preconditioning, which establishes the cause-effect relationship between activation of ecto-5'-nucleotidase and the infarct size-limiting effect. We also found that protein kinase C is responsible for the activation of ecto-5'-nucleotidase. Protein kinase C phosphorylated the serine and threonine residues of ecto-5'-nucleotidase. Therefore, we suggest that adenosine produced via ecto-5'-nucleotidase gives cardioprotection against ischemia and reperfusion injury. Also, we found that plasma adenosine levels are increased in patients with chronic heart failure. Ecto-5'-nucleotidase activity increased in the blood and the myocardium in patients with chronic heart failure, which may explain the increases in adenosine levels in the plasma and the myocardium. In addition, we found that further elevation of plasma adenosine levels due to either dipyridamole or dilazep reduces the severity of chronic heart failure. Thus, we suggest that endogenous adenosine is also beneficial in chronic heart failure. We propose potential mechanisms for cardioprotection attributable to adenosine in pathophysiological states in heart diseases. The establishment of adenosine therapy may be useful for the treatment of either ischemic heart diseases or chronic heart failure.

5'-Nucleotidase↗

PubMed1999

Improvement by 5-amino-4-imidazole carboxamide riboside of the contractile dysfunction that follows brief periods of ischemia through increases in ecto-5-nucleotidase activity and adenosine release in canine hearts.

5-Amino-4-imidazole carboxamide (AICA) riboside increases adenosine release in ischemic myocardium, suggesting that AICA riboside improves contractile dysfunction. In 49 open-chest dogs, contractile function assessed by fractional shortening (FS) was observed 3 h after the onset of reperfusion following 15 min of occlusion of the left anterior descending coronary artery. During reperfusion, the treatment with AICA riboside increased adenosine concentration in the coronary venous blood (536+/-44 vs. 281+/-21 pmol/ml at 3 min of reperfusion, p<0.001) and peak coronary hyperemic flow (367+/-13 vs. 300+/-21 ml/100 g per min, p<0.001) when compared with the untreated group. FS at 3h of reperfusion increased in the AICA riboside group (21.1+/-2.3 vs. 12.8+/-0.6% in the untreated group, p<0.001). AICA riboside increased myocardial ecto-5'-nucleotidase activity. Administration of adenosine also augmented coronary hyperemic flow and increased FS to the levels of the AICA riboside group. Either 8-phenyltheophylline (an antagonist of adenosine receptors) or alpha,beta-methylene-adenosine 5'-diphosphate (an inhibitor of ecto-5'-nucleotidase) completely abolished the increased coronary hyperemic flow and improvements of myocardial contractile function due to AICA riboside. Thus it was concluded that AICA riboside improves the contractile dysfunction that follows a brief period of ischemia via adenosine-dependent mechanisms.

5'-Nucleotidase↗

PubMed1999

[Actin depolymerizing action by marine toxin, pectenotoxin-2].

Pectenotoxin-2 (PCTX-2), which is one of Diarrhetic Shellfish Poisoning (DSP), is a family of cyclic polyether macrolide toxin isolated from scallop Patinopecten yessoensis. Although PCTX-2 has a potent cytotoxic activities against several cancer cell lines, the biochemical activity of PCTX-2 has not been determined yet. To clarify the biochemical activity of PCTX-2 is the aime in this study. PCTX-2 inhibited the contractions elicited by 72.7 mM KCl or 1 microM phenyrephrine in a concentration dependent manner in the isolated rat aorta. In A10 cells, actin stressfiber in center but not in periphery of the cell was disrupted by PCTX-2 without any visible shape change. By monitoring fluorescent intensity of pyrenyl-actin, PCTX-2 was found to inhibit the velocity and the degree of actin polymerization in a concentration dependent manner. In addition, PCTX-2 decreased viscosity of F-actin measured with falling ball viscometry. Stoichiometric analysis indicated that PCTX-2 forms 1:4 complex with G-actin. These results suggest that PCTX-2 is a potent natural actin depolymerizing compound with unique mode of action.

Actins↗

PubMed1999

The influence of chronic sympathectomy on cutaneous blood flow in the rat tail.

Tail blood flow (TBF) in the rat markedly increases during sympathetic withdrawal such as hyperthermia or lumbar sympathetic blockade. However, a long-term alteration of TBF after chronic sympathetic denervation is not well understood. In the present study, TBF following lumbar sympathectomy (LSX) was observed to ascertain whether subsequent changes in TBF occur in the absence of the sympathetic nervous activity in the rat tail. Assessed by recording tail and rectal temperature, the LSX immediately caused an increase in TBF. TBF was gradually decreased along with time and returned to the sham operated (SO) control level within 4 days. About a week after the surgery, a rapid increase in TBF in response to whole body heating was almost abolished in denervated animals. Neither hexamethonium (20 mg/kg, i.v.) for ganglion blockade nor intra-arterial infusion of alpha-receptor antagonist, phentolamine (10, 100 microg) produced vasodilation in LSX animals. Nitroprusside, a donor of nitric oxide, produced an increase in TBF in both LSX and SO animals. These results indicate that the tail vasculature after LSX constricts with capability to be vasodilated independent of sympathetic reinnervation. Quantification of the tail vascular mRNA expression by reverse transcriptase-polymerase chain reaction showed less endothelial nitric oxide synthetase in LSX group than that in SO group whereas endothelin-1 was not significantly different in both groups. It is suggested that functional changes in tail vascular endothelium takes at least a part in the reduction in TBF after LSX.

Animals↗

PubMed1999

Intermittent administration of human parathyroid Hormone(1-34) prevents immobilization-related bone loss by regulating bone marrow capacity for bone cells in ddY mice.

ddY mice, 6 weeks of age, were neurectomized (Nx) in the right hindlimbs and sham-operated (Sham) in the left limbs for evaluation of the effects of intermittent injections of human parathyroid hormone (hPTH) on trabecular bone turnover and bone marrow cell development in unloaded and loaded limbs. Mice were given subcutaneous injections of hPTH(1-34) five times a week at a dose of 0 (vehicle), 4 (low dose), or 40 (high dose) microg/kg of body weight for 2, 4, or 6 weeks. Histomorphometric analyses of the trabecular bone of the proximal tibiae revealed that high-dose hPTH injections preserved the trabecular bone volume of the Nx limbs, which was reduced after neurectomy, at the same level as that of the contralateral Sham limbs. The mineral apposition rate in the Nx limbs was elevated to values above even that of the Sham limbs by high-dose hPTH injections. The bone formation rate reduced by neurectomy was maintained at the Sham level by low- and high-dose hPTH injections. The neurectomy-induced increase in osteoclast number was suppressed by high-dose hPTH injections. In the bone marrow cells, the numbers of nonadherent and adherent cells per tibia obtained from the Nx and Sham limbs did not change. The hPTH injections decreased the numbers of nonadherent cells and increased those of adherent cells in both the Nx and the Sham limbs, but the effects were less marked in the Nx than in the Sham limbs even at high-dose injections. The formation of osteogenic nodules in the marrow cultures obtained from the Nx limbs was decreased after surgery and was maintained at the level of the Sham limbs by high-dose hPTH injections. The number of osteoclast-like multinucleated cells was reduced in the Sham limbs by high-dose hPTH injections. The value was increased at 2 weeks after neurectomy, but it was maintained at the Sham level by high-dose hPTH injections through the experimental period. The numbers of colony forming units-fibroblastic, which were reduced by neurectomy, and those of colony forming units for granulocytes and macrophages were not altered by hPTH injections. These results demonstrate that intermittent high-dose hPTH administration in the Nx limbs as well as in the contralateral Sham limbs has similar anabolic effects, stimulating osteoblast cell lineage and suppressing osteoclast cell lineage. The anabolic effects at 4 microg were reduced, but the effects at 40 microg seemed to be less affected by unloading due to sciatic neurectomy.

Animals↗

PubMed1999

Insulin resistance contributes to carotid arterial wall thickness in patients with non-insulin-dependent-diabetes mellitus.

The aim of this study was to clarify whether insulin resistance contributes to atherosclerosis in patients with non-insulin-dependent diabetes mellitus (NIDDM). Fifty-three NIDDM patients (36 males and 17 females, 53+/-10 years old (mean+/-SD)) were studied. As an index of atherosclerosis, we measured the average thickness (IMT) as well as basal thickness excluding the maximum thickness and the height of the maximum thickness of the carotid artery wall. Euglycemic hyperinsulinemic glucose clamp was conducted for 90 min to evaluate average glucose infusion rate (GIR) as an index of insulin sensitivity in the peripheral tissues. For another 180 min after intake of oral glucose load with 0.3 g/kg, the euglycemic hyperinsulinemic clamp was continued to measure ratio of splanchnic glucose uptake (SGU) as an index of insulin sensitivity of the liver. The patients were separated into three activity groups according to the grade of their leisure-time physical activity. GIR (r = -0.32, p < 0.05) but not SGU (r=0.139) showed a significant inverse relationship with IMT. Multivariant regression analysis indicated that age and total cholesterol remain as independent risk factors for basal thickness and GIR as only independent risk factor for the height of the maximum thickness. Paralleling the degrees of habitual exercise (low, moderate, and high active group), GIR was higher (6.19+/-1.02, 6.38+/-1.38, 7.44+/-1.80, respectively) and IMT was lower (1.34+/-0.33 mm, 1.20+/-0.31 mm, and 1.12+/-0.29 mm, respectively) in male NIDDM as well as in female NIDDM. These data suggest that insulin resistance in the peripheral tissues but not the splanchnic tissues may independently contribute to carotid arterial wall thickness and especially to plaque lesion, and that habitual exercise might reduce insulin resistance leading to attenuation of atherosclerosis.

Aged↗

PubMed1999

Late aneurysm of the distal aortic arch after repair of aortic interruption. A case report.

Aneurysm formation after aortic coarctation repair is not a rare complication of post-coarctation of aorta repair. We describe the case of a 43-year-old woman who had undergone repair of an isolated interruption of the aortic arch 30 years earlier, who came to our hospital with progressive chest pain, cough and dyspnea. A giant aortic aneurysm was revealed in the distal aortic arch by CT study. The patient underwent aneurysmectomy with total aortic arch replacement using a Dacron graft through redo median sternotomy. An embryologic explanation of this patient's anomaly and the previous surgical procedure are discussed for defining this rare clinical condition.

Adult↗

PubMed1999

Pseudoaneurysm of the subclavian artery due to Xanthomonas pneumonia in a patient with acute myeloid leukemia: its rupture treated by transcatheter coil embolization.

A 52-year-old male with acute myeloid leukemia developed pseudoaneurysm of the subclavian artery. Pneumonia due to Xanthomonas maltophilia, which was multi-drug resistant, progressed to a lung abscess even under administration of antibiotics. This lung infection contiguous to the left carotid and subclavian arteries was suggested to have caused the pseudoaneurysm of the subclavian artery. The rupture of the aneurysm by penetration to the trachea amounted to about 1,000 ml of bleeding; fortunately the bleeding ceased spontaneously. Nonetheless, an emergency transcatheter coil embolization prevented re-bleeding. Endovascular treatment should be considered especially for aneurysms which develop in patients with underlying diseases.

Aneurysm, False↗

PubMed1999

Diffusion-weighted single-shot echoplanar MR imaging for liver disease.

OBJECTIVE: The aims of this study were to determine apparent diffusion coefficients (ADCs) of the abdominal organs and liver lesions, to determine the effect of the magnitude of b values on the ADCs, and to determine whether measured ADCs of liver tumors help differentiate benign from malignant lesions. SUBJECTS AND METHODS: Six healthy volunteers and 126 patients were examined with diffusion-weighted single-shot echo-planar imaging using multiple b values (maximum, 846 sec/mm2). The ADCs of the liver, spleen, kidney, 49 malignant liver lesions (33 hepatocellular carcinomas, 15 metastatic liver tumors, and one cholangiocellular carcinoma), and 30 benign lesions (17 cysts, 12 hemangiomas, and one angiomyolipoma) were calculated. RESULTS: The ADCs of the abdominal organs and liver lesions showed smaller values when calculated with the greater maximum b values. The ADCs of the benign lesions calculated with all the b values of less than 850 sec/mm2 (2.49+/-1.39 x 10(-3) mm2/sec) were significantly (p = .0024) greater than those of the malignant lesions (1.01+/-0.38 x 10(-3) mm2/sec). When the maximum b value is 846 sec/mm2, use of a threshold ADC of 1.6 x 10(-3) mm2/sec would result in a sensitivity of 98% and a specificity of 80% for differentiation of malignant liver lesions from benign lesions. CONCLUSION: Measurement of ADC has good potential for characterizing liver lesions, but the calculated ADCs could be affected by the magnitude of the maximum b value.

Adult↗

PubMed1999

Detection of hepatocellular carcinoma: comparison of low- and high-spatial-resolution dynamic MR images.

OBJECTIVE: The purpose of our study was to compare the diagnostic performance of low- and high-spatial-resolution gadolinium chelate-enhanced triphasic dynamic gradient-recalled echo (GRE) MR images in the detection of hepatocellular carcinoma. MATERIALS AND METHODS: Triphasic dynamic MR images obtained with low (256 x 128) and high (512 x 224) image matrices in 28 patients with 65 hepatocellular carcinomas (HCCs) were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 215 liver segments, including 56 segments with tumor burden, were reviewed for the presence of HCC by three independent radiologists. Detectability was evaluated with relative sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Image quality was evaluated with rank order analysis. RESULTS: Relative sensitivity was statistically significantly better with high-spatial-resolution images than with low-spatial-resolution images (p < .005). Relative specificity was statistically significantly better with low-spatial-resolution images than with high-spatial-resolution images (p < .001). Diagnostic accuracy determined by ROC curve analysis was marginally higher with high-spatial-resolution (area under ROC curve [Az] = .97) than with low-spatial-resolution (Az = .94, p < .09) images. Image quality was statistically significantly better with high-spatial-resolution images (p < .005). CONCLUSION: High-spatial-resolution dynamic GRE images were superior to low-spatial-resolution images in sensitivity of detecting HCC and in image quality. Triphasic dynamic GRE imaging in the screening and follow-up programs of patients with suspected HCC should be performed using high image matrices.

Adult↗

PubMed1999

Worsening of pre-existing TMJ dysfunction following sagittal split osteotomy: a study of three cases.

When patients seeking treatment for malocclusion also suffer from temporomandibular joint (TMJ) disorders, it is hard to predict the result of simultaneous treatment of both conditions, or to plan for its different goals, because of unpredictable changes in the relationship between the disk, the fossa and the condylar head. Prediction is harder in cases of presurgical TMJ hypomobility, especially those with adhesion in the upper TMJ compartment. Authors differ widely on the likely effect of orthognathic surgery on TMJ disorders. This paper reports three cases in which TMJ disorders worsened after treatment of malocclusion by sagittal split osteotomy. It examines how presurgical diagnosis of TMJ disorders could assist treatment planning in such cases. The results suggest that microbleeding in the upper TMJ compartment during orthognathic surgery, as well as long-term postoperative intermaxillary fixation, carries a risk of creating worse adhesion that adversely affects the outcome for patients. Therefore, preoperative diagnosis of disk position and pathological conditions in the upper TMJ compartment, as well as careful choice of method and term of postoperative fixation, are essential in planning the treatment of malocclusion with sagittal split osteotomy.

Adolescent↗