This study investigated whether the presence of Mycoplasma fermentans (M. fermentans) in the temporomandibular joint (TMJ) could be associated with the pathology of temporomandibular joint disorders (TMD). One hundred fifteen synovial fluid (SF) samples from patients with TMD were evaluated for the presence of DNA of M. fermentans by polymerase chain reaction (PCR) assay. Specific antibody against M. fermentans was also detected in the SF as well as sera by Western blot analysis. M. fermentans DNA was identified in 37.4% of the SF samples from the TMD patients. There was no difference between PCR-positive and -negative rate regarding sex and disease categories, e.g., internal derangement (ID) and osteoarthritis (OA). However, the prevalence of M. fermentans DNA in ID patients was higher in elderly patients (73.3%) than in younger patients (31.8%). Anti-M. fermentans immunoreactivities (IgG) specific for lipoproteins with various molecular sizes, 56 kilo-Dalton (kDa), 48 kDa, 38 kDa, and 29 kDa, were also identified in the SF. The immunoreactivity was also detected in the patients'sera. The reactivity patterns of the anti-M. fermentans antibodies were, however, different between the SF and the sera; reactivities to 48 kDa and 29 kDa lipoproteins were prominent in the former, while the reactivities to those of 56 kDa, 48 kDa, and 29 kDa were evidently increased in the latter. The presence of specific DNA and antibody for M. fermentans in the TMJ implies that M. fermentans could possibly induce joint specific immunoreaction, thus perpetuating the inflammatory reaction in the diseased TMJ.

On the nursing front, there is no limit to demands for care services. Although efforts are being made to train the staff, letters from former inpatients showed that they left the hospital with a lot of discontent. To have them leave the hospital pleasantly, we have started holding an interview with the inpatients just before they are discharged since 2000. To grasp the results of the interviews accomplished during the 2-years period after the implementation of this program, we carried out a survey by distributing questionnaires to the nursing staff. At the same time, we conducted a survey on expatients and analyzed what they actually told the interviewers. It was found that about 60% of the outgoing patients were interviewed.More than 89% of the ex-patients surveyed said that they could calm themselves after they realized the nurses understood what it is to be painful. Asked if they want the interview to be continued, 94% answered in the affirmative. Meanwhile, many nurses said that what the patients told them was encouraging and gave them an incentive to carry out their duty. Some said that they were given an opportunity to reflect on their past conduct. All in all, we found that the interviews had the healing effect on the nursing staff as well as the patients.
Interview ; nursing therapy ; Discharge from hospital ; Effective ; Surveys