Cartilage attachment morphology of the fetal cruciate ligaments of the knee: an immunohistochemical study using human fetal specimens.

Fetal cruciate ligaments of the knee provide two types of cartilage attachments: to a cartilage fovea or a simple continuation to the perichondrium. To examine a difference in matrix substance between a ligament attachment to the fovea and another attachment to the perichondrium. We histologically observed 12 human fetal femurs in which the posterior (or anterior) cruciate ligament provided a fovea-type (or a perichondrium-type) attachment. Immunohistochemistry of matric substances (aggrecan, versican, tenascin-c) was performed. In the knees, aggrecan was consistently positive in any cartilage, versican was in the joint surface and tenascin-c in the perichondrium. In contrast to the femoral attachment, the anterior and posterior cruciate ligaments consistently continued to the perichondrium at the tibial attachment (versican-, tenascin+). In the femoral condyles, tenascin-immunoreactivity was seen in both of a fovea-type and a perichondrium-type attachments, but versican was not in both. During development of the cartilage fovea, the growing ligament seemed to push the perichondrium into the cartilage and, much or less, the tenascin-positive perichondrium was likely to be involved into the fovea.

Synovial tissue morphology of the cricoarytenoid joint in the elderly: a histological comparison with the cricothyroid joint.

We compared the age-related morphology of the cricothyroid (CT) joint with that of the cricoarytenoid (CA) joint using 18 specimens from elderly cadavers in terms of their elastic fiber contents as well as the cells composing the joint capsule and synovial tissues. In contrast to an almost flat-flat interface in the CT joint, the CA joint was similar to a saddle joint. The CA joint capsule was thin and contained few elastic fibers, and in contrast to the CT joint, external fibrous tissues were not exposed to the joint cavity, there being no injury to the CA joint capsule. The lateral and posterior aspects of the CA joint were covered by the lateral and posterior CA muscles, respectively, and the fascia of the latter muscle was sometimes thick with abundant elastic fibers. However, due to possible muscle degeneration, loose connective tissue was often interposed between the fascia and the capsule. The medial and anterior aspects of the CA joint faced loose tissue that was continuous with the laryngeal submucosal tissue. Therefore, in contrast to the CT joint, a definite supporting ligament was usually absent in the CA joint. Synovial folds were always seen in the CA joint, comprising a short triangular mass on the posterior side and long laminar folds on the anterior side. The synovial folds usually contained multiple capillaries and a few CD68-positive macrophages. High congruity of the CA joint surfaces as well as strong muscle support to the arytenoid cartilage appeared to provide the specific synovial morphology.

Evaluation of psychological factors in orthodontic patients with TMD as applied to the "TMJ Scale".

Physical and psychological evaluation have been required for TMD patients whose problems are multi dimensional. The questionnaire named the "TMJ Scale" was created to differentiate subjective TMD symptoms of patients. The purpose of this study was to clarify the reliability of the TMJ Scale for Japanese orthodontic patients with TMD and to differentiate the symptoms. Fifty orthodontic patients (average age 21y4m) with a chief complaint of TMD symptoms were compared with thirty patients (average age 21y1m) without TMD symptoms. The results were as follows: female patients in the symptom group in particular showed a higher degree of stress due to the chronic pain and abnormalities than those in the non-symptom group. Significant differences were observed in Pain Report, Joint Dysfunction and Global Scale at the 0.1% significant level, in Non-TM Disorder, Psychological Factor and Chronicity at the 1% level, and in Palpation Pain and Perceived Malocclusion at the 5% level in females. Few psychological problems were observed in male patients in the symptom group. Significant differences were observed in Range of Motion limitation at the 5% level in males. The differences in the psychological factors between male and female patients were clarified by using the TMJ Scale. These findings suggested that it was useful to differentiate the multiple symptoms, especially the psychological factors, by using the TMJ Scale for orthodontic patients with TMD.