Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism - a pilot study.

The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the 'hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0-10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies.

[Partial recovery of thermal sensory functions in skeletal Class â ¢ patients undergoing orthognathic surgery].

PURPOSE: To clarify whether trigeminal somatosensory function will be changed after orthodontic treatment as well as after orthognathic surgery. METHODS: A series of 20 patients with a mean age of 20.9±1.74 years were recruited. Thermal quantitative sensory tests were conducted before orthodontic treatment (T0), before orthognathic surgery (T1), 2 months after orthognathic surgery (T2), and 6 months after orthognathic surgery (T3). The cold detection threshold (CDT), cold pain threshold (CPT), warm detection threshold (WDT) and heat pain threshold (HPT) were determined. SPSS 16.0 software package was used for statistical analysis. RESULTS: There were significant differences with lower threshold (higher sensitivity) in V2L (P=0.006) and V2R (P=0.017) for WDT at T1 compared to T0. A significantly higher threshold (lower sensitivity) was detected for CDT in V2L (P=0.028) at T1 compared to T0. A significantly higher threshold (lower sensitivity) was detected for HPT in V2R (P=0.028) and V3R (P=0.017) at T1 compared to T0. There were significant differences with higher threshold (lower sensitivity) V3L (P=0.024) for WDT at T3 compared to T0. A significantly lower threshold (higher sensitivity) was detected for CPT in V2R (P=0.036), V3L (P=0.012) and V3R (P=0.044) at T3 compared to T0. There were significant differences with higher threshold (lower sensitivity) in V2L (P=0.009), V2R (P=0.034), V3L (P=0.032) and V3R (P=0.001) for HPT at T3 compared to T0.Numbness was reported most frequently at T2 (93.33%), but this symptom tended to decrease with time (T3-20%).Fisher's exact test showed that there was no significant difference at T2(P=0.303) and T3(P=0.530) between participates who underwent genioplasty or not. CONCLUSIONS: The results indicated that thermal somatosensory function was altered after initial orthodontic treatment and orthognathic surgery. However, partial recovery of thermal sensory function can be expected in the majority of patients.

Predictive factors of thyroid cancer in patients with Graves' disease.

BACKGROUND: The best preoperative examination in Graves' disease with thyroid cancer still remains uncertain. The objectives of the present study were to investigate the prevalence of thyroid cancer in Graves' disease patients, and to identify the predictive factors and ultrasonographic features of thyroid cancer that may aid the preoperative diagnosis in Graves' disease. METHODS: This retrospective study included 423 patients with Graves' disease who underwent surgical treatment from 2002 to 2012 at our institution. The clinical features and ultrasonographic findings of thyroid nodules were recorded. The diagnosis of thyroid cancer was determined according to the pathological results. RESULTS: Thyroid cancer was discovered in 58 of the 423 (13.7 %) surgically treated Graves' disease patients; 46 of those 58 patients had thyroid nodules, and the other 12 patients were diagnosed with incidentally discovered thyroid carcinomas without thyroid nodules. Among the 58 patients with thyroid cancer, papillary microcarcinomas were discovered in 50 patients, and multifocality and lymph node involvement were detected in the other 8 patients. Multivariate regression analysis showed younger age was the only significant factor predictive of metastatic thyroid cancer. Ultrasonographic findings of calcification and intranodular blood flow in thyroid nodules indicate that they are more likely to harbor thyroid cancers. CONCLUSIONS: Because the influencing factor of metastatic thyroid cancers in Graves' disease is young age, every suspicious nodule in Graves' disease patients should be evaluated and treated carefully, especially in younger patients because of the potential for metastasis.

[Survey of vitamin D status in 700 healthy adult males in Guiyang, China].

OBJECTIVE: To evaluate the vitamin D status of healthy adult males living in Guiyang. METHODS: A total of 700 healthy volunteers aged 20 - 79 years were selected randomly from a community in Guiyang by stratified sampling method. Questionnaires for living habits and fasting blood samples were collected in the morning from November 2009 to January 2010. The serum concentrations of 25-hydroxyvitamin D were measured by the DiaSorin radioimmunoassay kit. RESULTS: The mean levels of serum 25(OH)D was (21 ± 10) µg/L. And the percentages of vitamin D deficiency (25(OH)D < 20 µg/L), insufficiency (20 µg/L ≤ 25(OH)D < 30 µg/L) and sufficiency (25(OH)D ≥ 30.0 µg/L) were 315(50.2%), 202 (32.2%) and 110(17.6%)respectively. The concentrations of serum 25(OH)D in young, middle-aged and old adults were (18 ± 10) µg/L, (24 ± 10) µg/L and (22 ± 8)µg/L respectively. The serum level of 25(OH)D was lower in the smokers than that in the non-smokers (20 µg/L vs 22 µg/L, P = 0.003). The serum concentrations of 25(OH)D were (24 ± 10) µg/L, (23 ± 10) µg/L, (22 ± 9) µg/L and (18 ± 9) µg/L in education level (≤ 6, 7 - 9, 10 - 12 and ≥ 10 years in school) respectively. Significant inverse correlations existed between the concentrations of serum 25(OH)D and the education levels (r = -0.138, P = 0.000). CONCLUSION: The prevalence of hypovitaminosis D is common in healthy adult males in Guiyang, especially among the youth, smokers and higher educated groups.

[A study of electric information monitoring in the treatment of bruxism with occlusal splint].

OBJECTIVE: An electric monitor of bruxism had been invented in order to evaluate the curative effect of cuspid occlusal upheaving splint and stabilization splint. METHODS: 20 patients with bruxism were randomly divided into two groups. A cuspid occlusal upheaving splint or a stabilization splint was fabricated respectively for patients. The vertical dimension for each splint was 0.5 mm lower than mandibular postural position. Sleeping time, bruxist time and times of bruxism were recorded with bruxism monitor that was invented for studying bruxing. RESULTS: The bruxist time and the times of bruxism were decreased obviously in patients with cuspid occlusal upheaving splint, while no significant difference was shown before and after using the stabilization splint. CONCLUSIONS: The bruxism monitor can automatically measure and record the data of bruxism with splint, which is valuable for clinic. The curative effect of cuspid occlusal upheaving splint is better than that of stabilization splint for treating bruxism.

Apoptosis in the adult striatum after transient forebrain ischemia and the effects of ischemic severity.

The mechanisms of neuronal injury after cerebral ischemia have been under active investigation. The medium-size neurons in the dorsal striatum die within 24 h after transient cerebral ischemia. Using electron microscopy, the present study examined the nature of neuronal death in the striatum of adult rats following transient forebrain ischemia and tested the hypothesis that the ischemic severity might influence the nature of cell death. After severe ischemia (approximately 21 min ischemic depolarization), most neurons in the dorsal striatum died with swollen organelles and small irregular chromatin clumps resembling necrosis. The tissue damage in the dorsomedial striatum was less severe than that in the dorsolateral striatum and approximately 5% of the neurons in this region died with large chromatin clumps and relatively intact organelles resembling apoptosis. Some neurons displayed a mixture of necrotic- and apoptotic-like appearance. In contrast, the neurons with large somata only exhibited mild ultrastructural changes. After moderate ischemia (approximately 15 min ischemic depolarization), the tissue damage was less severe and the process of necrosis was temporally prolonged compared with that after severe ischemia. The apoptotic-like neuronal death was observed not only in the dorsomedial (approximately 6%) but also in the dorsolateral striatum (approximately 7%). The neurons in the striatum showed transient reversible changes after mild ischemia (approximately 10 min ischemic depolarization). The present study demonstrates that both apoptosis and necrosis occur in the adult striatum following transient forebrain ischemia and apoptosis occurs in the regions with less severe ischemia. These results suggest that ischemic severity might be one of the contributing factors to necrosis or apoptosis following transient global ischemia.