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The relationship between clinical and MRI findings were statistically evaluated. The data were analysed by Kruskal Wallis and Mann Whitney U test. Chi-square (x2) test was used for categorical variable comparisons. P values  less then  .05 were considered to indicate statistical significance. RESULTS Clinical and MRI records of 700 TMJ, from 350 patients with the mean age of the 31 (12-65) were evaluated in this study. Statistically significant differences were found between; disc position and pain, disc position and JE; JE and pain; disc structural distortion and pain; and disc structural distortion and disc position. JE was seen more common in DDWOR group. The most common disc distortion, seen in patients with JE, is the folded type. CONCLUSIONS The present study can infer that pain is associated with disc position, JE, disc structural distortion, and DDWOR is associated with JE. Folded type disc is the most common disc type in TMJ with JE.BACKGROUND Phosphatase and tensin homolog (PTEN) acts as a tumor suppressor gene. Inactivation of PTEN has been reported in various types of cancers. PTEN promoter methylation possibly underlies PTEN inactivation, which results in tumorigenesis. The aim of this study was to investigate whether PTEN promoter methylation contributes to PTEN inactivation in ameloblastoma and its associated protein expression. MATERIAL AND METHODS In total, 20 fresh-frozen ameloblastoma samples were evaluated for PTEN promoter methylation using methylation-specific polymerase chain reaction (MS-PCR). A subset of 10 paraffin-embedded ameloblastoma samples was examined for PTEN expression through immunohistochemistry. Four primary cultured ameloblastoma cells were investigated for PTEN promoter methylation and PTEN transcriptional expression via reverse transcription PCR. RESULTS PTEN promoter methylation was detected in 65% (13/20) of the ameloblastoma samples. see more Of 10 ameloblastoma samples, 4 exhibited reduced PTEN expression. Of 5 samples with methylated PTEN, 3 (60%) were associated with loss of PTEN expression. However, PTEN expression was detected in 4 (80%) of 5 samples with unmethylated PTEN. In addition, 3 (75%) of 4 primary ameloblastoma cell cultures exhibited an inverse correlation between PTEN promoter methylation and PTEN transcription level. CONCLUSIONS PTEN promoter methylation is found in a number of ameloblastomas but not significantly correlated with loss of PTEN expression. Genetic or epigenetic mechanisms other than PTEN promoter methylation may contribute to PTEN inactivation in ameloblastoma tumor cells.BACKGROUND Population-based surveys estimate that 0.7% of youth (13 to 17 y of age) in the United States identifies as transgender. Transgender youth are at an increased risk of anxiety, depression, and suicide attempts that often require inpatient care. Unfortunately, because of perceived insensitivity to gender identity from their providers, which includes incorrect use of names and/or pronouns, they may delay seeking necessary care. To date, there have been no specific documentation practice guidelines published by the International Association of Child and Adolescent Psychiatry and Allied Professions, American Academy of Child and Adolescent Psychiatry (AACAP), or other professional associations. The main goal of this study was to review documentation practices among multidisciplinary teams caring for hospitalized transgender youth on a child and adolescent inpatient psychiatry unit. METHODS Retrospective chart reviews were completed for 44 transgender patients who were hospitalized between 2008 and 2017.actices for youth transgender inpatients. Further work is necessary to understand the implications of these findings for patient satisfaction and clinical outcomes.Obsessive-compulsive disorder (OCD) with poor insight can contribute to the refusal to receive treatment, leaving the burden of care on parents or other caregivers. The case presented here involved a young adult with OCD with delusional levels of insight paired with extreme family-accommodating behaviors that had resulted in impaired quality of life and functioning for the young adult and his parents. A parent-led behavioral intervention [The Supportive Parenting for Anxious Childhood Emotions (SPACE)] that was developed for children with anxiety was adapted and utilized for a young adult with severe OCD. The case presents a treatment option for parents and caregivers of individuals with OCD who refuse treatment.Tianeptine is an atypical mu-opioid receptor agonist. It is available as an antidepressant outside the United States, but it is also classified as a controlled substance in many other countries. It is not approved by the United States Food and Drug Administration for the treatment of depression but it can be obtained online without a prescription. The case described in this article involved a patient who developed symptoms of psychosis on supratherapeutic doses of tianeptine, highlighting the importance of inquiring into all supplements taken by patients when conducting an initial psychiatric evaluation.It is common for not only laypersons but also courts, witnesses, attorneys, and even some experts involved in a criminal sexual assault investigation to confuse the terms "blackout" and "pass out" when referring to the memory, consciousness, and other behavioral ramifications of alcohol intoxication. A typical alcohol-involved sexual assault allegation often includes the partial or total absence of memory for events of the alleged incident. The etiology and behavioral presentations of the types of alcohol-induced memory deficiency evidenced are not all created equal and understanding the differences is crucial to understanding the reasonableness of the potential perceptions or misperceptions of an accused. By improving our understanding of these terms, we can assist the legal process with proper and more accurate history gathering and documentation if we become a party to such an investigation.This column is the second in a series summarizing the 2-day Centennial Conference of the Austen Riggs Center. The conference framed problems in access to care and in the nature of the care being provided that are part of a mental health crisis in America, and then worked to propose solutions. This column addresses problems with the nature of care provided, proposing psychodynamic perspectives that offer hope through engagement. Such approaches play a role in "bending the curve" to improve mental health outcomes.