Signs and Symptoms of Temporomandibular Dysfunction in Fibromyalgic Patients

Objective: The objective of this study was to determine the frequency of signs and symptoms of temporomandibular disorder (TMD) in fibromyalgic patients. Methods: Sixty subjects of both sexes (mean age, 49.2 +/- 13.8 years) with fibromyalgia (FM) diagnosis were included in this study. All patients were examined by a calibrated investigator to identify the presence of TMD using the Research Diagnostic Criteria for TMD. Results: The most common signs (A) and symptoms (B) reported by FM patients were (A) pain in the masticatory muscles (masseter, 80%; posterior digastric, 76.7%), pain in the temporomandibular joint (83.3%), and 33.3% and 28.3%, respectively, presented joint sounds when opening and closing the mouth; (B) headache (97%) and facial pain (81.7%). In regard to the classic triad for the diagnosis of the TMD, it was found that 35% of the FM patients presented, at the same time, pain, joint sounds, and alteration of the mandibular movements. It was verified that myofascial pain without limitation of mouth opening was the most prevalent diagnosis (47%) for the RDC subgroup I. For the subgroup II, the disk displacement with reduction was the most prevalent diagnosis (21.6%). For the subgroup III, 36.7% of the subjects presented osteoarthritis. Conclusions: Thus, there is a high prevalence of signs and symptoms of TMD in FM patients, indicating the need for an integrated diagnosis and treatment of these patients, which suggest that the FM could be a medium- or long-term risk factor for the development of TMD.

Coronoid process hyperplasia: an unusual cause of mandibular hypomobility

A large number of disorders affecting the masticatory system can cause restriction of mouth opening. The most common conditions related to this problem are those involving the temporomandibular joint (TMJ) and the masticatory muscles, when facial pain also is an usual finding. Congenital or developmental mandibular disorders are also possible causes for mouth opening limitation, although in a very small prevalence. Coronoid process hyperplasia (CPH) is an example of these cases, characterized by an excessive coronoid process growing, where mandibular movements become limited by the impaction of this structure on the posterior portion of the zygomatic bone. This condition is rare, painless, usually bilateral and progressive, affecting mainly men. Diagnosis of CPH is made based on clinical signs of mouth opening limitation together with imaging exams, especially panoramic radiography and computerized tomography (CT). Treatment is exclusively surgical. This paper presents a case of a male patient with bilateral coronoid process hyperplasia, initially diagnosed with bilateral disk displacement without reduction, and successfully treated with intraoral coronoidectomy. It is emphasized the importance of differential diagnosis for a correct diagnosis and, consequently, effective management strategy.

How Should the Articular Disk Position Be Analyzed?

Purpose: To compare 2 methods used to determine the disk position based on sagittal magnetic resonance images. Patients and Methods: A cross-sectional study of patients with the signs and symptoms of temporomandibular disorders was conducted. The patients' ages and gender distributions were collected. The disk position diagnosis from the clinical examination was considered the primary outcome. Three observers evaluated the presence of anterior displacement on magnetic resonance images according to 2 criteria: method 1 (12-o'clock position) and method 2 (location of the intermediate zone). To assess the intraobserver variability of the 2 methods, the examiners evaluated the same magnetic resonance images at the beginning of the study (time 1) and 40 days later (time 2). The intraobserver agreement was assessed using the observed agreement and the kappa statistic. McNemar's test was used to assess the differences between each method and the clinical examination findings (P < .05). The accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by comparing the diagnosis from each method with that from the clinical examination (considered the reference standard). Results: The final sample was composed of 20 subjects with a mean age of 33.0 +/- 33.7 years; 3 were men (15%) and 17 were women (85%). A statistically significant difference between the 2 methods was found. Method 1 yielded a greater percentage of anterior displaced disks (52.5%). The agreement between the clinical diagnosis and method 1 was lower (70.0%) than that between the clinical diagnosis and method 2 (87.5%). No statistically significant difference was found between the clinical diagnosis and method 2. Conclusion: The disk position should be judged according to the intermediate zone criterion. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:1534-1539, 2012

Laminar Displacement and Prelaminar Tissue Thickness Change after Glaucoma Surgery Imaged with Optical Coherence Tomography

PURPOSE. To study changes in lamina cribrosa position and prelaminar tissue thickness (PTT) after surgical IOP reduction in glaucoma patients. METHODS. Twenty-two patients (mean age, 71.4 years) were imaged with spectral domain optical coherence tomography (SD-OCT; 24 radial B-scans centered on the optic nerve head [ONH]) before trabeculectomy or tube shunt implantation. Follow up images were acquired 1 week, 1 month, 3 months, and 6 months postsurgery. Bruch's membrane opening (BMO), the internal limiting membrane (ILM) and the anterior laminar surface (ALS) were segmented in each radial scan with custom software. Surfaces were fitted to the ILM and ALS with the extracted three-dimesional coordinates. PTT was the distance between the ILM and ALS, perpendicular to a BMO reference plane. Serial postsurgical laminar displacement (LD), relative to the BMO reference plane, and changes in PTT were measured. Positive values indicated anterior LD. RESULTS. Mean (SD) presurgery IOP was 18.1 (6.5) mm Hg, and reduced by 4.7 (5.5), 2.4 (7.7), 7.0 (6.2), and 6.8 (7.5) mm Hg at 1 week, 1 month, 3 months, and 6 months postsurgery, respectively. At the four postsurgery time points, there was significant anterior LD (1.8 [9.5], -1.1 [8.9], 8.8 [20.2], and 17.9 [25.8] mu m) and PTT increase (1.7 [13.3], 2.4 [11.9], 17.4 [13.7], and 13.9 [18.6] mu m). LD was greater in ONHs with larger BMO area (P = 0.01) and deeper ALS (P = 0.04); however, PTT was not associated with any of the tested independent variables. CONCLUSIONS. Both anterior LD and thickening of prelaminar tissue occur after surgical IOP reduction in patients with glaucoma. (Invest Ophthalmol Vis Sci. 2012;53:5819-5826) DOI:10.1167/iovs.12-9924

Behaviour of displacement piles in sand under cyclic axial loading

Field experiments have demonstrated that piles driven into sand can respond to axial cyclic loading in Stable, Unstable or Meta-Stable ways, depending on the combinations of mean and cyclic loads and the number of cycles. An understanding of the three styles of responses is provided by experiments involving a highly instrumented model displacement pile and an array of soil stress sensors installed in fine sand in a pressurised calibration chamber. The different patterns of effective stress developing on and around the shaft are reported, along with the results of static load tests that track the effects on shaft capacity. The interpretation links these observations to the sand's stress strain behaviour. The interface-shear characteristics, the kinematic yielding, the local densification, the growth of a fractured interface-shear zone and the restrained dilatancy at the pile soil interface are all found to be important. The model tests are shown to be compatible with the full-scale behaviour and to provide key information for improving the modelling and the design rules. (C) 2012 The Japanese Geotechnical Society. Production and hosting by Elsevier B.V. All rights reserved.

THE FIRST DETERMINATION OF THE VISCOSITY PARAMETER IN THE CIRCUMSTELLAR DISK OF A Be STAR

Be stars possess gaseous circumstellar decretion disks, which are well described using standard alpha-disk theory. The Be star 28 CMa recently underwent a long outburst followed by a long period of quiescence, during which the disk dissipated. Here we present the first time-dependent models of the dissipation of a viscous decretion disk. By modeling the rate of decline of the V-band excess, we determine that the viscosity parameter alpha = 1.0 +/- 0.2, corresponding to a mass injection rate (M) over dot = (3.5 +/- 1.3) x 10(-8) M-circle dot yr(-1). Such a large value of a suggests that the origin of the turbulent viscosity is an instability in the disk whose growth is limited by shock dissipation. The mass injection rate is more than an order of magnitude larger than the wind mass-loss rate inferred from UV observations, implying that the mass injection mechanism most likely is not the stellar wind, but some other mechanism.

Alkaline sulfite/anthraquinone pretreatment followed by disk refining of Pinus radiata and Pinus caribaea wood chips for biochemical ethanol production

BACKGROUND: Alkaline sulfite/anthraquinone (ASA) cooking of Pinus radiata and Pinus caribaea wood chips followed by disk refining was used as a pretreatment for the production of low lignified and high fibrillated pulps. The pulps produced with different delignification degrees and refined at different energy inputs (250, 750 and 1600 Wh) were saccharified with cellulases and fermented to ethanol with Saccharomyces cerevisiae using separated hydrolysis and fermentation (SHF) or semi-simultaneous saccharification and fermentation (SSSF) processes. RESULTS: Delignification of ASA pulps was between 25% and 50%, with low glucans losses. Pulp yield was from 70 to 78% for pulps of P. radiata and 60% for the pulp of P. caribaea. Pulps obtained after refining were evaluated in assays of enzymatic hydrolysis. Glucans-to-glucose conversion varied from 20 to 70%, depending on the degree of delignification and fibrillation of the pulps. The best ASA pulp of P. radiata was used in SHF and SSSF experiments of ethanol production. Such experiments produced maximum ethanol concentration of 20 g L-1, which represented roughly90% of glucose conversion and an estimated amount of 260 L ethanol ton(-1) wood. P. caribaea pulp also presented good performance in the enzymatic hydrolysis and fermentation but, due to the low amount of cellulose present, only 140 L ethanol would be obtained from each ton of wood. CONCLUSION: ASA cooking followed by disk refining was shown to be an efficient pretreatment process, which generated a low lignified and high-fibrillated substrate that allowed the production of ethanol from the softwoods with high conversion yields. (C) 2012 Society of Chemical Industry

New activity in the large circumstellar disk of the Be-shell star 48 Librae

Aims. Spectroscopic, polarimetric, and high spectral resolution interferometric data covering the period 1995-2011 are analyzed to document the transition into a new phase of circumstellar disk activity in the classical Be-shell star 48 Lib. The objective is to use this broad data set to additionally test disk oscillations as the basic underlying dynamical process. Methods. The long-term disk evolution is described using the V/R ratio of the violet and red emission components of H alpha and Br gamma, radial velocities and profiles of He I and optical metal shell lines, as well as multi-band BVRI polarimetry. Single-epoch broad-band and high-resolution interferometric visibilities and phases are discussed with respect to a classical disk model and the given baseline orientations. Results. Spectroscopic signatures of disk asymmetries in 48 Lib vanished in the late nineties but recovered some time between 2004 and 2007, as shown by a new large-amplitude and long-duration V/R cycle. Variations in the radial velocity and line profile of conventional shell lines correlate with the V/R behavior. They are shared by narrow absorption cores superimposed on otherwise seemingly photospheric He I lines, which may form in high-density gas at the inner disk close to the photosphere. Large radial velocity variations continued also during the V/R-quiet years, suggesting that V/R may not always be a good indicator of global density waves in the disk. The comparison of the polarization after the recovery of the V/R activity shows a slight increase, while the polarization angle has been constant for more than 20 years, placing tight limits on any 3-D precession or warping of the disk. The broad H-band interferometry gives a disk diameter of (1.72 +/- 0.2) mas (equivalent to 15 stellar radii), position angle of the disk (50 +/- 9)degrees and a relatively low disk flattening of 1.66 +/- 0.3. Within the errors the same disk position angle is derived from polarimetric observations and from photocenter shifts across Br gamma. The high-resolution interferometric visibility and phase profiles show a double or even multiple-component structure. A preliminary estimate based on the size of the Br gamma emitting region indicates a large diameter for the disk (tens of stellar radii). Overall, no serious contradiction between the observations and the disk-oscillation model could be construed.

Planetary nebulae and determination of the bulge-disk boundary

In this paper, a sample of planetary nebulae in the Galaxy's inner-disk and bulge is used to find the galactocentric distance that optimally separates these two populations in terms of their abundances. Statistical distance scales were used to investigate the distribution of abundances across the disk–bulge interface, while a Kolmogorov–Smirnov test was used to find the distance at which the chemical properties of these regions separate optimally. The statistical analysis indicates that, on average, the inner population is characterized by lower abundances than the outer component. Additionally, for the α-element abundances, the inner population does not follow the disk's radial gradient toward the Galactic Center. Based on our results, we suggest a bulge–disk interface at 1.5 kpc, marking the transition between the bulge and the inner disk of the Galaxy as defined by the intermediate-mass population.

The Gemini planet-finding campaign: the frequency of giant planets aroud debris disk stars

We have completed a high-contrast direct imaging survey for giant planets around 57 debris disk stars as part of the Gemini NICI Planet-Finding Campaign. We achieved median H-band contrasts of 12.4 mag at 0.''5 and 14.1 mag at 1'' separation. Follow-up observations of the 66 candidates with projected separation <500 AU show that all of them are background objects. To establish statistical constraints on the underlying giant planet population based on our imaging data, we have developed a new Bayesian formalism that incorporates (1) non-detections, (2) single-epoch candidates, (3) astrometric and (4) photometric information, and (5) the possibility of multiple planets per star to constrain the planet population. Our formalism allows us to include in our analysis the previously known β Pictoris and the HR 8799 planets. Our results show at 95% confidence that <13% of debris disk stars have a ≥5 M Jup planet beyond 80 AU, and <21% of debris disk stars have a ≥3 M Jup planet outside of 40 AU, based on hot-start evolutionary models. We model the population of directly imaged planets as d 2 N/dMdavpropm α a β, where m is planet mass and a is orbital semi-major axis (with a maximum value of a max). We find that β < –0.8 and/or α > 1.7. Likewise, we find that β < –0.8 and/or a max < 200 AU. For the case where the planet frequency rises sharply with mass (α > 1.7), this occurs because all the planets detected to date have masses above 5 M Jup, but planets of lower mass could easily have been detected by our search. If we ignore the β Pic and HR 8799 planets (should they belong to a rare and distinct group), we find that <20% of debris disk stars have a ≥3 M Jup planet beyond 10 AU, and β < –0.8 and/or α < –1.5. Likewise, β < –0.8 and/or a max < 125 AU. Our Bayesian constraints are not strong enough to reveal any dependence of the planet frequency on stellar host mass. Studies of transition disks have suggested that about 20% of stars are undergoing planet formation; our non-detections at large separations show that planets with orbital separation >40 AU and planet masses >3 M Jup do not carve the central holes in these disks.