Otologic complaints, including otalgia, tinnitus, vertigo, and hearing loss, are known to be related to temporomandibular disorders (TMDs). There have been several hypotheses regarding the clinical correlation between otologic complaints and TMDs, based on clinical phenomena with corresponding symptoms, the close neurological relationship between otic and masticatory structures, and anatomical features of the tympanic cavity and jaw joint. Function of the tensor tympani muscle seems to be crucial to understanding TMD-related otologic symptoms. The tensor tympani inserts into the handle of the malleus and it modulates sound transduction in situations of excessive noise. This muscle is innervated by the trigeminal nerve, like the masticatory muscles. Voluntary eardrum movement by pathological tensor tympani contraction results in various otologic symptoms. Thus, co-contraction of the tensor tympani with the masticatory muscle could be a possible cause of TMD-related otologic symptoms. The tensor tympani is rather unrelated to the acoustic reflex, in which the stapedius is strongly involved. The tensor tympani seem to be controlled by proprioceptive information from the trigeminal sensory nucleus. The peripheral innervation pattern of the tensor tympani and masticatory muscles is also supposed to be interconnected. The middle ear structure, including the malleus, incus, and tensor tympani, of mammals had been adapted for acoustic function and lacks the masticatory role seen in non-mammalian jawed vertebrates. The tensor tympani in non-mammals is one of the masticatory muscles and plays a role in the modulation of sound transduction and mastication. After the functional differentiation of the mammalian middle ear, the nervous connection of the tensor tympani with other masticatory apparatus still remains. Through this oto-stomatognathic vestige, the tensor tympani seems to contract unnecessarily in some pathological conditions of the TMD in which the masticatory muscles contract excessively. We hypothesized that the phylogenic relationship between the tensor tympani and masticatory apparatus is a significant and logical reason for TMD-related otologic complaints.
Acoustics ; Ear, Middle ; Earache ; Hearing Loss ; Incus ; Jaw* ; Joints ; Logic ; Malleus ; Mammals ; Mastication ; Masticatory Muscles ; Noise ; Reflex, Acoustic ; Stapedius ; Temporomandibular Joint Disorders ; Tensor Tympani* ; Tinnitus ; Trigeminal Nerve ; Tympanic Membrane ; Vertebrates ; Vertigo

BACKGROUND: Human growth hormone(hGH) plays a central role in linear bone growth and body metabolism. Its mitogenic effect in human tissues is mediated via direct and indirect actions. As proposed by the "somatomedin hypothesis", many circulating GH-mediated effects are exerted indirectly and systemically via stimulation of hepatic synthesis of insulin-like growth factor 1(IGF-1). Given additional evidences for the expression of growth hormone receptor(GH-R) and IGF-1 receptor(IGF-1R) on many target tissues including keratinocytes, melanocytes, and fibroblasts, it is now evident that the GH can act via systemic IGF-1 secreted by the liver and locally produced IGF-1, as well as directly through the GH receptor. OBJECTIVE: The purpose of this study was to investigate not only the effect of IGF-1 on the morphologic changes, proliferation, and melanization of cultured human melanocytes but also on its signal transduction pathway through the IGF-1R. METHODS: Melanocytes were exposed to IGF-1 at 10, 25, 50, 75, 100ng/ml and we examined the changes of cell morphology, number of cells, [3H]-thymidine incorporation, MTS assay, and melanization according to the concentrations and exposure times of IGF-1. Also, the activity of p44/42 MAPK/ERK according to the various exposure times of IGF-1(25ng/ml) was examined using the Western blotting method to find out about the signal transdution pathway of IGF-1. RESULTS: The results were as follows: 1. There were no significant morphological changes of cells between the control and experimental groups according to the concentrations and exposure times of IGF-1. 2. The effects on melanocytes according to the concentrations of IGF-1 5 days after adding IGF-1 : 1) The number of cells, [3H]-thymidine incorporation, and MTS assay were significantly higher than those of control group in all experimental groups(p<0.05). 2) The melanin content showed an insignificant decrease in all experimental groups. 3) The melanocytes responded independent of the IGF-1 concentration in the assay of cell number, [3H]-thymidine incorporation and MTS. 3. The effects on melanocytes according to the exposure times(3 days, 5 days, 7 days) of IGF-1(25 ng/ml) : 1) The number of cells, [3H]-thymidine incorporation, and MTS assay increased as time went by, and was significantly higher than those of control group at all exposure times(p<0.05). 2) The melanin content decreased after exposure of IGF-1, especially that of 3 days exposure group showed a significant decrease(p<0.05). 4. The activities of p44/42 MAPK/ERK increased suddenly at 5 minutes with a peak at 60 minutes and then abruptly decreased at 120 minutes after adding IGF-1 CONCLUSION: In summary, this study demonstrates that IGF-1 has no effect on the morphology, but it does increase the proliferation and slightly decrease the melanization of cultured human melanocytes. In addition, it is suggested that IGF-1 plays a role in regulation of proliferation of melanocytes via the receptor PTK pathway with activation of p44/42 MAPK/ERK.
Blotting, Western ; Bone Development ; Cell Count ; Fibroblasts ; Growth Hormone ; Humans* ; Insulin-Like Growth Factor I* ; Keratinocytes ; Liver ; Melanins ; Melanocytes* ; Metabolism ; Signal Transduction

The authors investigated the antiproliferative effect and expression of HLA-DR an- tigen by recombinant gamma-interferon (r-IFN-y) on cultured human keratinocytes (KC). The results were as follows, 1. From 10l.J/ml of r-1FN-p exposure, the proliferation of KC decreased in a concentration dependent fashion. But there was little difference of antiproliferative effect above 30U/ml of r-IFN-y exposure. 2. The expression of HLA-DR antigen on KC increased in a concentration and time dependent fashion of r-IFN-p exposure. E3ut t,here was little difference of HLA-DR antigen expression on KC above 30tJ/ml and most of HLA-DR antigen were expressed within 48hr. 3. The opt,imal condition for HLA-DR antigen induction on KC by r-IFN-p was likely t,hat HLA-DR KC was observed at 48hr under the our exposure of 30U/ml of r-IFN p. 4. After 4hr exposure of 30U/ml of r-IFN-p, KC expresed HLA-BR. antigen, reaching a maximum intensity at 3 days. At, 7 days, the loss of HI A-DR KC showed over 90% of maximum intensity.
HLA-DR Antigens* ; Humans* ; Interferon-gamma ; Interferons* ; Keratinocytes*

The term halo congenital nevus is a condition in which halo formation is associated with congenital melanocytic nevus. The regression of congenital melanocytic nevi is usually accompanied by the halo phenomenon and this is considered to be a rare event, although this may be underestimated. We describe here a 9-year-old boy with verrucous congenital nevus surrounded by a depigmented halo on the right upper arm. Histologically, the nevus lesion revealed a dense lymphocytic infiltration in the upper dermis intermingled with some remnants of nevus cell nests. Most of the infiltrating cells were CD8+ T lymphocytes. At the edge of the lesion, corresponding to the area of the halo, neither melanocytes nor melanin were found in any significant amounts.
Arm ; Child ; Dermis ; Humans ; Melanins ; Melanocytes ; Nevus ; Nevus, Pigmented ; T-Lymphocytes

BACKGROUND: Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease of an unknown etiology, and this is characterized by spiking fever, evanescent rash, arthritis and multiorgan involvement. OBJECTIVE: This study was conducted to better understand the clinical characteristics of patients with AOSD, and especially the cutaneous features. METHODS: We reviewed the medical records and cutaneous findings of 21 patients who were diagnosed with AOSD at our hospital from 2003 to 2009. The diagnosis of AOSD was based on the criteria proposed by Yamaguchi et al. RESULTS: Eighteen (86%) out of the 21 patients were women, and the age of onset ranged from 18 to 55 years. Fever occurred in 21 (100%) patients, skin rash in 20 (95%), arthralgia in 18 (86%), sore throat in 10 (48%) and lymphadenopathy in 7 (33%). The cutaneous features were as follows: typical maculopapular eruption (70%), urticaria (10%), petechia and purpura (10%), persistent plaques and linear pigmentation (5%) and acne-like lesions (5%). The most common sites of skin lesion were the trunk (80%) and thighs (80%). The histopathologic findings of 9 patients showed non-specific chronic inflammation with a perivascular mononuclear preponderance in 6 patients, and the others were consistent with urticaria or leukocytoclastic vasculitis. CONCLUSION: The various cutaneous features of this study suggest that dermatologists should consider AOSD in any patient with cutaneous eruption associated with fever and arthralgia.
Adult ; Age of Onset ; Arthralgia ; Arthritis ; Exanthema ; Female ; Fever ; Humans ; Inflammation ; Lymphatic Diseases ; Medical Records ; Pharyngitis ; Pigmentation ; Purpura ; Skin ; Still's Disease, Adult-Onset ; Thigh ; Urticaria ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

The aim of the study is to examine the distribution and communications of the trigeminal nerve (TN) and facial nerve (FN) and considerate their relationship with the anatomy and function of the facial expression muscles (FEMs) by means of the literature study. The TN emerged on the face via various structures of the skull, and received sensation of the skin and muscles on the face. The FN supplied the motor components to the FEMs, as ramifying five branches after running through the stylohyoid foramen. The TN and FN constituted "nervous communication between heterogeneous cranial nerves" on the ocular (supraorbital nerve and temporal branch), zygomatic (zygomatic nerve and temporal/zygomatic branch), infraorbital (infraorbital nerve and zygomatic branch), retromandibular (auriculotemporal nerve and FN trunk), buccal (buccal nerve and buccal/zygomatic branch) and mental areas (mental nerve and buccal/marginal mandibular branch). The exquisite movement of the FEM which was controlled by the facial motor nucleus would be referred by the proprioception from the TN. The motor components from the FN could be delivered to the FEM via the TN as recruiting the heterogeneous nervous communications. The sensation from the FN also could be conveyed to the TN via the communication.
Facial Expression ; Facial Nerve ; Muscles ; Proprioception ; Running ; Sensation ; Skin ; Skull ; Trigeminal Nerve

We have experienced a case of pseudocyst of transverse mesocolon in 3-year-old male child. Operative findings showed that the pseudocyst was originated from the transverse mesocolon, and was not connected to the pancreas. A colonic duplication has been also found incidentally near the pseudocyst. On microscopic examination of specimen, ectopic pancreatic tissue was noted in transverse mesocolon. We think that this pseudocyst may be originated from the ectopic pancreas of the transverse mesocolon. To our knowledge, this is the first case of pseudocyst originated from ectopic pancreas associated with colonic duplication, and the pathogenesis is discussed.
Child ; Child, Preschool ; Colon* ; Humans ; Male ; Mesocolon* ; Pancreas*

We report a case of lymphocutaneous sporotrichosis with unusual clinical features in a 62-year-old male patient, who presented with a painless, well-defined psoriasiform plaque and central ulceration on the dorsam of the right hand which progressively spread into the lymphatics draining area. The fully matared lesions produced a chain of firm. mild prickling subcutaneous nodules on both upper extremities probably due to autoinoculation. The biopsy specimen of the lesion showed hyperkeratosis with chronic granulomatous inflammation and PAS-positive fungal spores in the dermis. Sporothrix schenckii was identified using a fungal culture of tissue specimen. The lesions improved with treatment of a topical antifungal agent and KI solution at the dose of 2 g/day for 1 month, but returned to initial cutaneous manifestation due to the patient failing to the treatment.
Biopsy ; Dermis ; Hand ; Humans ; Inflammation ; Male ; Middle Aged ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Upper Extremity

No abstract available.
Carcinoma, Basal Cell ; Keratosis, Seborrheic