A case of zoster sine herpete of the trigeminal nerve

Varicella-zoster virus reactivation causes zoster (shingles), a syndrome characterized by severe pain and a vesicular rash. The present report details a case of varicella-zoster virus reactivation of the maxillary and mandibular division of the right trigeminal nerve without evidence of vesicular rash (zoster sine herpete). It is difficult to identify owing to no typical clinical signs such as vesicular eruption. Zoster sine herpete of the trigeminal nerve, in particular, is rarely reported. In this case, the diagnosis was based on clinical findings and was supported by the demonstration of an immunoglobulin G antibody. Zoster sine herpete of the trigeminal nerve, in particular, should be considered in patients with severe facial pain over specific dermatomes, if they do not demonstrate appreciable findings of traumatic neuropathy, tumor or herpes zoster.     

Relationship between the strength of glass ionomers and their adhesive strength to metals.

OBJECTIVES: The objective of this study was to examine the possible correlation between the strength of glass ionomers and their adhesive strength to metals. METHODS: Three different brands of glass ionomers mixed at four different P/L ratios were evaluated. The compressive and diametral tensile strengths of the cements were determined. The shear bond strengths were determined between four different types of dental casting alloys and the cement made with the different P/L ratios. RESULTS: Significant (p < 0.05) increases in the bond strength to any of the metal surfaces were found in the cement specimens mixed at the highest P/L ratio compared to those mixed at the lowest P/L ratio. For two glass ionomers (FI and DNT), the specimens prepared at the highest P/L ratio showed significantly greater diametral tensile strength than those prepared at the lowest P/L ratio (p < 0.05). SIGNIFICANCE: The present study showed a significant correlation between diametral tensile strengths and bond strengths. It is suggested that the use of glass ionomers with high mechanical strength is an important factor of enhancing the adhesion to metal surfaces.     

Abdominal oblique muscle injury at its junction with the thoracolumbar fascia in a high school baseball player presenting with unilateral low back pain

Abdominal oblique muscle injury is characterized by acute pain and localized tenderness over the lateral trunk. This injury is particularly common among throwing athletes, and usually presents as anterolateral abdominal wall pain. Imaging evidence is scarce in regard to whether oblique muscle injury at its junction with the thoracolumbar fascia can instead present with low back pain. A high school baseball player with unilateral low back pain was referred to us with a different diagnosis. Careful palpation and magnetic resonance imaging guided our care, and the patient returned to high-level competition after 7 weeks of conservative treatment, with no report of recurrence in the subsequent 12 months. Oblique muscle injury at its junction with the thoracolumbar fascia should be added to the differential diagnosis for throwing athletes with unilateral low back pain following a torque movement.     

Acute oral selenium intoxication with ten times the lethal dose resulting in deep gastric ulcer

A 48-year-old woman presented after taking 2000 mg of selenium dioxide, corresponding to 10 times the experimental lethal dose in animals. She presented with mildly altered consciousness and hematemesis. Endoscopy revealed mucosal damage throughout the oral cavity, esophagus, and stomach. There was no evidence of perforation. After intubation and gastric lavage, hemodialysis was performed. The patient was discharged uneventfully on the 16(th) day. This case highlights a very rare acute selenium intoxication. Serum and urinary selenium levels and serum glutathione peroxidase activities during the patient's course were followed, as well as the mucosal corrosive damage caused by the selenium.