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A case of Epstein-Barr virus infection with exophthalmos and ocular muscle swelling.

A 14-year-old girl with Epstein-Barr virus (EBV) infection developed exophthalmos and ocular muscle swelling. The EBV genome was detected in T lymphocytes taken from the submandibular gland, temporal muscle and cervical lymph nodes. A surface marker analysis of her peripheral blood demonstrated that CD45RO-positive T lymphocytes were strongly activated. Immunosuppressive treatment, including steroid and cyclophosphamide, was effective in improving the symptoms. Immunosuppressive therapy may be included as the choice of treatment for EBV infection.

Adolescent↗

Flexibility in motor-unit firing pattern in the human temporal and masseter muscles related to type of activation and location.

Morphological studies have shown that each human jaw muscle and its sub-portions have a characteristic fibre-type pattern, suggesting special functional tasks. The firing pattern of 68 low-threshold motor units in different portions of the temporal and masseter muscles in 5 healthy subjects were determined by single-fibre EMG during voluntary isometric muscle contraction. The findings showed that each unit may have different activity patterns for different types of activation, which is not so for limb muscles. Thus, a given motor unit discharged with a different regularity in firing rate during retraction of the mandible than during clenching of the jaws in the intercuspal position, probably related to a changed central and peripheral influence on the motoneurone pool. No activity of single units was detected in the mandibular rest position. The results underline the complexity of the human stomatognathic system and the importance of combined morphological and physiological studies.

Adolescent↗

EMG power spectrum patterns of anterior temporal and masseter muscles in children and adults.

The power spectrum of electromyograms (EMG) has been demonstrated to vary with muscles having different muscle fiber type compositions. This study investigated the variations in EMG power spectrum patterns of the masticatory muscles with age and gender by comparison of the mean power frequency (MPF) of the anterior temporal and masseter muscles in children and adults. Surface EMG signals were sampled bilaterally from the muscles when the subjects were performing maximum voluntary isometric clenches at maximal intercuspal position. The results indicated that MPF values were age-dependent (p less than 0.001), and sexual dimorphism was evident (p less than 0.001), with lower MPF values in male and adult muscles. While male adults had the lowest and female children had the highest MPF values, female adults had MPF values closer to values obtained from male children. These differences or similarities could be attributed to the degree of differentiation of the muscles during growth and development of the craniofacial morphology.

Adult↗

[Metastasizing basalioma of the temporal area or continuous extension? Surgical approach and results].

By means of histological sections the rare diagnosis of a basalioma of the temporal area with regional metastases in the parotid gland and in the neck could be verified. Subsequently the surgical treatment and the postoperative results are described. The operation consisted of an en bloc excision of the basalioma, exstirpation of the parotid gland and radical neck dissection. Since the tumor had also infiltrated the facial nerve, the nerve had to be sacrificed and reconstructed using the superficial peroneal nerve. In order to obtain immediately a satisfactory esthetic result in the face region, in addition to the facial nerve graft, the corner of the mouth and the eyelids were taken up using solvent dehydrated dura mater and parts of the temporal muscle and its fascia. A face-lifting supported this procedure. The primary closure of the temporal skin defect was successfully performed using a regional skin flap from the scalp.

Adult↗

Influence of experimental interfering occlusal contacts on the activity of the anterior temporal and masseter muscles during submaximal and maximal bite in the intercuspal position.

The effects of an intercuspal occlusal interference on the pattern of activity of the anterior temporal and masseter muscles during submaximal and maximal bite, were studied in eleven volunteers with complete, natural dentitions. The results show that, during maximal and submaximal bite an occlusal interference (about 0.5 mm) in the intercuspal position is able to disturb the almost symmetric pattern of muscular activity in the anterior temporal and masseter muscles. Further, the level of muscular activity during maximal bite decreased significantly in all muscles studied. In some subjects, the decrease of muscular activity could still be observed one week after insertion of the interfering contact. After eliminating the interference, the muscular co-ordination pattern improved and the level of muscular activity increased significantly.

Adult↗

An electromyographic study of the immediate effect of an occlusal splint on the postural activity of the anterior temporal and masseter muscles in different body positions with and without visual input.

With the mandible at rest, the clinical postural position was measured and electromyographic recordings (in seated and supine position, eyes open and eyes closed, before as well as 15 min after insertion of an occlusal splint) were from the anterior temporal and masseter muscles in thirty-one patients with signs and symptoms of mandibular dysfunction and nocturnal bruxism. The results indicated that when the patients were seated upright, there was a distinct postural activity in the anterior temporal and in some patients also in the masseter muscles. This postural activity decreased significantly with closure of the eyes and in supine position. Fifteen minutes after insertion of an occlusal splint, the postural activity in the temporal muscles decreased in 52%, increased in 22% and remained unchanged in 26% of the patients. Moreover, the postural activity reached its lowest level in supine position. The results indicate that the supine position is the body position to be preferred for centric relation recording as well as for occlusal and splint adjustment.

Adolescent↗

The influence of altered working-side occlusal guidance on masticatory muscles and related jaw movement.

The effect of four different occlusal situations (group function, canine guidance, working side occlusal interference, and hyperbalancing occlusal interference) on EMG activity in jaw elevator muscles and related mandibular movement was investigated on 12 subjects. With a computer-based system, EMG and displacement signals were collected simultaneously during specific functional (unilateral chewing) and parafunctional tasks (mandibular gliding movements and various tooth clenching efforts) and analyzed quantitatively. When a naturally acquired group function was temporarily and artificially changed into a dominant canine guidance, a significant general reduction of elevator muscle activity was observed when subjects exerted full isometric tooth-clenching efforts in a lateral mandibular position. The original muscular coordination pattern (relative contraction from muscle to muscle) remained unaltered during this test. With respect to unilateral chewing, no significant alterations in the activity or coordination of the muscles occurred when an artificial canine guidance was introduced. Introduction of a hyperbalancing occlusal contact caused significant alterations in muscle activity and coordination during maximal tooth clenching in a lateral mandibular position. A marked shift of temporal muscle EMG activity toward the side of the interference and unchanged bilateral activity of the two masseter muscles were observed. The results suggest that canine-protected occlusions do not significantly alter muscle activity during mastication but significantly reduce muscle activity during parafunctional clenching. They also suggest that non-working side contacts dramatically alter the distribution of muscle activity during parafunctional clenching, and that this redistribution may affect the nature of reaction forces at the temporomandibular joints.

Adult↗

Renal cell carcinoma: late recurrence in 2 cases.

We present 2 patients with late recurrence 16 and 11 years after nephrectomy for renal cell carcinoma. Metastases were solitary and their location very uncommon (vastus externo muscle and colon). In the reviewed series of 5,758 patients with renal cell carcinoma only a temporal muscle metastasis and another in the colon were observed but none of them was solitary.

Aged↗

[A clinical and physiological evaluation of the unilateral occlusal deficit and its RPD treatment--a four-year follow-up study].

The aim of this study was to evaluate the longitudinal clinical and physiological changes in masticatory function for unilateral shortened arch, partially edentate patients by treatment with removable partial denture prostheses from the denture insertion over approximately four years of observation. The present follow-up study was conducted using objective findings and standpoints of unilateral occlusal deficit case, especially the clinical and physiological relation between musculature activity and changes of load center location periodically. The changes in masticatory functions by the muscle activity observed in EMG, and the occlusal loads and distributions throughout the arc, were surveyed by the modified Prescale system. The findings were statistically analyzed by using a sophisticated computer system that was developed by our research institute. The results were as follows: i) The functional musculature of unilateral shortened arc patients was clearly activated by using the unilateral RPD, and the improvements continued for four years after initial denture insertion. ii) The activation of masticatory muscle by denture-wearing over time, was in edentate side masseter, although the amplification of anterior temporal muscle was distinct in mandibular cases. iii) The muscle activity during rhythmical motion, such as tapping with denture-wearing, increased about two times than that of two and three years from the starting edentate value similarly to the clenching values within the measured period. iv) The masticatory efficacy of unilateral free end saddle prosthodontics was estimated using the changes in I-EMG values during peanut mastication. These findings suggested that the use of RPD accomplished an arc form and improved masticatory function for agglomeration of foods and masticatory efficiency over time.

Adult↗

Major clinical and histopathological characteristics of canine X-linked muscular dystrophy in Japan, CXMDJ.

Canine X-linked muscular dystrophy (CXMD), which was found in a colony of golden retriever, is caused by a mutation in the dystrophin gene and it is a useful model of Duchenne muscular dystrophy (DMD). To investigate the pathogenesis and to develop therapy of DMD, we have established a beagle-based CXMD colony in Japan (CXMDJ) and examined their phenotypes. The mortality by 3 days of age in the third generation (G3) of CXMDJ dogs, 32.3%, was considerably higher than that in normal G3 littermates, 13.3%. Serum creatine kinase (CK) levels of G3 CXMDJ were significantly higher than that of normal male dogs with two peaks: at shortly after birth and around 2 months of age. Diaphragm muscle involvement occurred shortly after birth and was more severe than that of limb muscles. Stress during whelping might be associated with the neonatal death and respiratory muscle involvement. Gait disturbance was also noticed after 2 months of age. The involvement of limb and temporal muscles was observed from 2 months of age, which corresponded with the second peak of serum CK. Macroglossia, dysphagia, drooling and jaw joint contracture were overt from 4 months of age. We noticed severe macroglossia and hypertrophy of the sublingual muscles at the age of 12 months, and these were important features of this model, because dysphagia is one of major symptoms in older DMD patients. Overall, the phenotypes of CXMDJ were roughly identical to those of CXMD dogs in the literature. Beagle-based CXMDJ is smaller and easier to handle than golden retriever, therefore they are a useful model for DMD.

Animals↗

[Postural examination in daily occlusodontology].

According to the osteopathic and chiropractic concepts, facing a TMJ problem, the practitioner has to determine if the trouble observed in the stomatognatic apparatus is the cause or the effect of the structural problems present anywhere else in the body. The postural examination allows to answer this question. Tow techniques can be used. First a static and dynamic posture test proposed by Bricot. The level of the cranium, the eyes, the shoulders, the wrists, the pelvis and the ankles is analysed, from a front view; from the side, the gravity line is inspected: vertex, auditory meatus, shoulder, hip joint, anterior side of the tibia, ankle joint. The vertical posture can be studied from the front: the arms are held straight and the antero-posterior length between the fingers is measured. From the back, one notes the recoil of the buttocks on one side. An ocular convergence test is performed. Then one uses a Romberg test (oscillation of the body when the eyes are closed), and a Fukuda stepping test. The patient is then asked to bite on a compress, and the same exams are redone. If no change occurs, we are dealing with an ascending problem: the origin of the problem is not the stomatognathic system. The second technique is the Meerssemann test that needs the practice of Applied Kinesiology muscle testing. The patient is lying supine and one tests: the dental occlusion, the two TMJs, the temporal muscles, masseters, pterygoids, sterno-cleido-mastoids, upper tapezius, left and right sacro-iliac joints, psoas muscles bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Occlusion↗

Tooth contact patterns and contractile activity of the elevator jaw muscles during mastication of two different types of food.

The pattern of molar and canine contacts and the contractile activity of the masseter and anterior temporal muscle were studied, through integrated electromyography, during right-sided mastication of banana and apple in ten healthy male subjects. Tooth contacts occurred on both the chewing and the non-chewing side. This study does not support the clinical concept that non-chewing side contacts are necessarily detrimental to the jaw muscles and the temporomandibular joints. The activity of the elevator jaw muscles and the tooth contact patterns suggest that the mandible tilted around a sagittal axis, and rotated around a vertical axis, during the phase of elevation of a masticatory cycle.

Adult↗

Temporomandibular disorders: a pilot study of activation patterns and motor unit analysis of jaw muscles.

Ten patients exhibiting chronic signs and symptoms of temporomandibular dysfunction were investigated with electromyography (EMG) and compared with a group of healthy controls. A quantitative analysis of 20 individual motor units as well as single fibre recordings of the most symptomatic muscle was performed on five patients. One of these patients showed clear signs of myopathy in her right temporal muscle. Surface jaw muscle EMG of the other five patients showed co-contractions of agonists and synergists during jaw opening and closing movements. This may indicate disturbances in the integrated motor unit activity. The background of these findings may therefore be found in the function of the muscle fibre as well as in segmental and suprasegmental disturbances. Recent research has suggested a role of chemosensitive afferent endings in development of excitatory fusimotor reflexes.

Adult↗

[The effect of deture relining on the electromyogram of masticatory muscles in complete denture wearers].

The aim of present study is to assess the effect of complete denture relining on the electromyogram of masticatory muscles. The electromyography and the computer-EMG system were used for collecting and processing bilateral masseter and anterior temporal muscles activities before and after denture relining. The results showed that the mean myoelectric potentials of the masticatory muscles was increased during chewing and maximal biting when the dentures were relined. The conclusion was that the level of the masticatory muscle activity was increased when a clinically acceptable occlusal vertical dimension was obtained by using relining method.

Adult↗

[Functional morphology of the maxillo-mandibular apparatus of the mini-Lewe minipig. 7. Intramuscular nerve ramification model of the masseter muscle of juvenile animals].

The ramification patterns are basically the same at all ages. The existing patterns of intramuscular innervation change gradually only by increasing ramification. The masseter and zygomaticomandibularis muscles are innervated jointly by branches of the massetericus nerve. The medial pterygoid muscle is supplied by 2 branches. In 3 d old animals the lateral pterygoid muscle is supplied by a single branch, but 2 branches are already present in animals aged 2 months. The temporal muscle is innervated by 5 branches.

Aging↗

[Successful reconstruction of a skull base fracture with frontal lobe contusion by omental transplantation for recurrent posttraumatic tension pneumocephalus: a case report].

In July 1983, 26 year-old male was admitted to our neurosurgical clinic after severe head injury caused by a car accident. Recovery of consciousness was delayed for months due to bilateral frontal lobe contusions with anterior skull base fractures on both sides. He was first discharged 6 months after surgery for ventriculo-peritoneal shunting. He was readmitted to our department due to an episode of urinary incontinence with gait disturbance 11 months after the accident. CT film of the head revealed the presence of an air shadow at the left frontal base. Utilizing lyophyllized dura mater, the first cranial surgery for closure of cerebrospinal fluid leakage was carried out in July, 1984. Pneumocephalus with meningitis recurred again five years later. Repeated conventional surgery failed including a transsphenoidal and transfrontal sinus approach to treat the recurrent pneumocephalus. In order to close the defect in the skull base, and to obliterate the dead space in the left frontal lobe, vital tissue transplantation was planned. On May 23, 1990, seven years after the accident, the skull base defect was repaired by suturing fascia taken from the temporal muscle. Then the patient's vascularized omentum was utilized as an autograft by micro-surgical technique. A superficial temporal artery and vein, and superficial sylvian vein were used to vascularize the omentum. The patient has been totally free of pneumocephalus for more than three and half years following the radical surgery. Clinical omental transplantation using microsurgical technique for vascularization of cerebral circulation as well as plastic surgery has been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗