The influence of percussion, occlusion and mastication on the occurrence of silent periods in masseter muscle activity

The occurrence of silent periods in masseter muscle activity was investigated during percussion of the bony structures of the head and neck, during occlusion of the teeth on surfaces of varying hardness, and during chewing of different food-stuffs. Silent periods were demonstrated on percussion during isometric and isotonic contraction of the masseter muscles and the occurrence of silent periods was influenced by the force of occlusion and by the nature of the surface contacted. Mandibular velocity was investigated during tapping and chewing sequences by ultra-high-speed cinematography, but it was not found possible to identify a critical change in mandibular velocity associated with the occurrence of silent periods. More silent periods were observed during the chewing of hard foods than of soft foods and there were more silent periods near the beginning of chewing sequences than towards the end. Differences in latency and duration of silent periods were observed in relation to artificial changes in the occlusion.     

Single Transseptal Big Cryoballoon Pulmonary Vein Isolation using an Inner Lumen Mapping Catheter

Background: The single big cryoballon technique for pulmonary vein isolation (PVI) has been limited by the need for two transseptal punctures (TP). We therefore investigated feasibility and safety of a simplified approach using a single TP and a novel circumferential mapping catheter (CMC). Methods: Patients underwent 28‐mm cryoballoon PVI using a single TP. The CMC (Achieve^© Medtronic Inc., Minneapolis, MN, USA) served as (1) guidewire and (2) as a PV mapping tool. Primary endpoint was PVI without switching to a regular guidewire. Secondary endpoints included: (1) PV signal quality during freezing, (2) time to PVI, (3) classification of successful ablation technique, (4) complications, and (5) procedural data. Results: A total of 32 patients (126 PVs) were studied (mean age: 62 ± 11 years, 24 males, left atrium: 40 ± 4 mm). The primary endpoint was achieved in 29/32 patients (91%) and 123/126 PVs (98%) with a procedure and fluoroscopy time of 126 ± 26 minutes and 18.9 ± 7.5 minutes, respectively. Real‐time visualization of PVI could be observed in 61/126 (48%) PVs. Time to sustained PVI versus nonsustained PVI was 66 ± 56 seconds versus 129 ± 76 seconds (P < 0.001). One phrenic nerve palsy was observed. After a follow‐up of 250 ± 84 days 23/32 patients (72%) remained in sinus rhythm. Conclusion: The “simplified single big cryoballoon” PVI strategy appears to be safe and feasible. However, real‐time PV recording was achieved in <50% of PVs. Therefore, further catheter refinements are warranted. (PACE 2012; 35:1304–1311)     

Relapse of brucellosis simulating testis tumor

We report on a case of a 32-year-old man referred for evaluation of a painless left testicular mass suggesting a testicular tumor. Previous history was uneventful except for a 3-year history of systemic brucellosis without epididymo-orchitis. Radical inguinal orchidectomy was performed. Clinical and histopathological findings indicated a brucellar abscess of the left testis. Even in the absence of systemic symptoms, the possible relapse of brucellosis as an abscess formation in the testis should be considered as a rare cause of testicular mass in patients who live in endemic regions.     

Effect of ascorbic acid treatment on endothelium-dependent and neurogenic relaxation of corpus cavernosum from middle-aged non-insulin dependent diabetic rats

AIMS: The purpose of the present study was to investigate functional responses and nitric oxide synthase activity in the corpus cavernosum of young control, middle-aged control and middle-aged non-insulin dependent diabetic rats. METHODS: The animal groups were treated with ascorbic acid. RESULTS: Acetylcholine-mediated endothelium-dependent relaxation of cavernosal tissue was significantly attenuated from a maximum of 58.0 +/- 4.1% (1 mmol, n = 10) in young rats to 44.3 +/- 1.6% in aged-matched controls (P < 0.05) and to 23.3 +/- 2.8% in non-insulin-dependent diabetes mellitus rats (P < 0.01). These deficits in acetylcholine responsiveness were completely prevented by ascorbic acid treatment. Non-adrenergic non-cholinergic relaxations evoked by electrical field stimulation (0.5-64.0 Hz) in the corpus cavernosum of middle-aged control and non-insulin dependent (NID) diabetic rats are blunted and were not restored by ascorbic acid. The histochemical findings demonstrated a decrease of nicotinamide adenine dinucleotide phosphate-diaphorase staining in the cavernosal tissue obtained from middle-aged control rats and middle-aged diabetic rats. CONCLUSION: Partial correction by ascorbic acid may suggest the importance of reactive oxygen species and a therapeutic approach in impotent NID diabetic men.     

Reconstruction of Lower Eyelid Defects Using a Cross Upper Eyelid Flap Composited with Ear Cartilage

BACKGROUND: Basal cell carcinomas (BCC) most frequently involve the lower eyelid and are treated with total excision. Various techniques have been proposed for reconstruction of the excised eyelid. OBJECTIVE: Because most flaps used in such techniques are bulky, thinner, and aesthetically more favorable, flaps have been sought recently. METHODS: Defects of the lower lid have been closed with a combination of cross-flaps and choncal cartilage prepared from the upper eyelid. RESULTS: Eleven lower lids from 10 patients operated for BCC were reconstructed. All flaps survived. The duration of follow-up was 10 months, and no complications such as relapse, ectropion, or lagophthalmus occurred. CONCLUSIONS: The upper eyelid flap was found to be an appropriate cover for both the skin and the conjunctiva due to its hairless and smooth structure. The outcome in patients followed up for a mean of 10 months was successful, cosmetically and functionally.     

Penile Kaposi''s sarcomas in a circumcised and HIV-seronegative patient

Kaposi's sarcoma (KS) limited to penis is rare and usually observed in AIDS patients. However, in circumcised and HIV-seronegative patients, KS confined to the penis is extremely rare. We present the case of an HIV-seronegative and circumcised 55-year-old man, who presented with two reddish papules, one 5 mm in diameter on the coronal sulcus near the frenulum, and the other 2 mm in diameter on the glans penis, which were reported as a Kaposi's sarcoma after excision of the lesion.