Chewing-side preference (CSP) may be associated with temporomandibular disorders. However, little information exists regarding whether CSP will lead to osseous changes of temporomandibular joint (TMJ) in asymptomatic participants. The aim of this study was to investigate the relationship between osseous morphology of TMJ in asymptomatic participants with CSP and without CSP. Of the 121 healthy dentate participants, 35 participants with left CSP, 38 with right CSP and other 48 without CSP were scanned by cone-beam computed tomography. The dimensions of the reconstructed images of opposing TMJs were compared. Statistical analyses were performed using spss 16.0 software. The results showed that there were no significant differences between the dimensions of bilateral structures of the TMJ (P1 > 0·05) in participants without CSP. However, the posterior-superior, posterior and lateral joint space of the preferred side were smaller than that of the unpreferred side in participants with CSP (P2 < 0·01) and bilateral TMJ in participants without CSP (P3 < 0·01). In addition, width of condylar neck of the unpreferred side both in sagittal and perpendicular to the long axis of condyle views was greater than that of the preferred side in participants with CSP (P2 < 0·01) and bilateral TMJ of participants without CSP (P4 < 0·01). Also, the inclination of articular eminence of the preferred side in view perpendicular to the long axis of condyle was less than that of the unpreferred side (P2 < 0·05). These findings suggest CSP affects osseous morphology of TMJ in asymptomatic participants.
Outbreak of Mycobacterium tuberculosis infections associated with acupuncture has not been reported. Thirteen patients with a painful swollen lump were referred to our hospital. The index patient received acupuncture and paraspinal muscular injection at a local acupuncture clinic in April 2011 and was diagnosed with M. tuberculosis 1 month later. From May 2011 to August 2011, 12 more patients with a swollen lump on the nuchal region or in the lower back or the buttocks region were referred to our hospital. Tuberculin skin test (TST), T-SPOT.TB, acid-fast stain, M. tuberculosis culture, chest radiograph, and lump magnetic resonance imaging (MRI) were performed and the patients were diagnosed with tuberculous abscess of the lump. All 13 patients received intramuscular injection at the paraspinal muscle by two acupuncturists at a local clinic and reported a swollen lump at the injection site. The needles and syringes were reused after autoclave sterilization. The TST was positive in all patients. Twelve patients had positive acid-fast stains. Mycobacterial cultures of abscess specimens were positive in all 13 patients. T-SPOT.TB tests were positive in all patients who underwent the test. The lesions and biopsies were subjected to polymerase chain reaction (PCR) and gene sequencing by the Disease Control Center of Zhejiang Province, China and the causative agent was identified as M. tuberculosis, Beijing type. In conclusion, physicians should consider the possibility of mycobacterial infections, apart from other bacterial agents, in patients with a swollen paraspinal lump following intramuscular injection.
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