Orofacial neuralgia associated with a middle cerebral artery aneurysm

Chronic orofacial pain of neuropathic origin can present diagnostic and management dilemmas to dental practitioners and also affects the patient's quality of life. Intracranial aneurysms are a potential cause of stroke (e.g. sub‐arachnoid haemorrhage) that is usually associated with, high rates of mortality and morbidity. A patient who had been previously managed for symptoms of temporomandibular joint disorder (TMD) presented with sharp, shooting pain of moderate intensity. It was precipitated by swallowing, and radiated to the right throat, posterior border of the mandible, ear and temporomandibular joint. Clinical and radiological investigations ruled out odontogenic pain, TMD and other more common types of facial pain. Magnetic resonance imaging revealed a 7 × 6 mm aneurysm in the right middle cerebral artery (MCA) which was subsequently surgically clipped. Interestingly, the facial pain resolved after this procedure. Compression of the insular region of the brain innervated by the trigeminal, glossopharyngeal and vagus nerves provides a plausible explanation for the pain reported. To our knowledge, this is the first case of facial neuralgia associated with an aneurysm in the MCA which emphasizes the importance of a multidisciplinary approach in the diagnosis and management of unusual cases of chronic orofacial pain.     

The Effects of Decreasing Maternal Anxiety on Fetal Oxygenation and Nucleated Red Blood Cells Count in the Cord Blood

Objective: Vasoconstriction during anxiety reduces fetal oxygenation and leads to hypoxia. Hypoxia in turn results in increase of the number of nucleated red blood cells (NRBCs) in the cord blood. The present study aimed to assess the effect of decreasing maternal anxiety on fetal oxygenation and NRBCs count in the cord blood. Methods:. In this study, 150 women were randomly divided into two intervention groups [supportive care and acupressure in BL32 (bladder) acupoint] and a control group (hospital routine care). The infants'' cord blood was investigated regarding the number of NRBCs and the intensity of hypoxia after birth. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using ANOVA, Chi-square test, and logistic regression analysis. Findings : The significant difference was found between the two groups regarding the number of NRBCs counted in the peripheral blood smear (P<0.001). Besides, a significant relationship was observed between the length of the first and second stages of labor and the number of NRBCs in the cord blood (P=0.01). Also, a significant association was observed between the type of delivery and the number of NRBCs in the cord blood in both intervention (P<0.001) and control groups (P=0.03). Conclusion: Doula supportive care and acupressure at BL32 point reduced the length of labor stages as well as the anxiety level. Also, nucleated red blood cells were less in the 2 groups of intervention than in control group. Regarding the fact that nucleated red blood cells cannot be the only factor for hypoxia predicting, for affirmation of this theory study with higher sample size and survey of mothers at high risk are needed.Key Words: Acupressure; Anxiety; Delivery Outcome; Doula     

Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and in the nasal cavity of the mouse

Vaziri Sani F, Kaartinen V, El Shahawy M, Linde A, Gritli‐Linde A. Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and nasal cavity of the mouse. Eur J Oral Sci 2010; 118: 221–236. © 2010 The Authors. Journal compilation© 2010 Eur J Oral Sci The aim of this study was to analyse the hitherto largely unknown expression patterns of some specific cellular and extracellular molecules during palate and nasal cavity development. We showed that epithelia of the developing palate and the vomerine epithelium express similar sets of structural proteins. With the exception of keratin 15, which becomes barely detectable in the elevated palatal shelves, nearly all of these proteins become upregulated at the presumptive areas of fusion and in the adhering epithelia of the palate and nasal septum. In vivo and in vitro analyses indicated that reduction in the amount of keratin 15 protein is independent of Tgfβ–Alk5 signalling. Foxa1 expression also highlighted the regionalization of the palatal and nasal epithelia. Owing to the lack of reliable markers of the palatal periderm, the fate of peridermal cells has been controversial. We identified LewisX/stage‐specific embryonic antigen‐1 as a specific peridermal marker, and showed that numerous peridermal cells remain trapped in the medial epithelial seam (MES). The fate of these cells is probably apoptosis together with the rest of the MES cells, as we provided strong evidence for this event. Heparan sulphate, chondroitin‐6‐sulphate, and versican displayed dynamically changing distribution patterns. The hitherto‐unknown innervation pattern of the developing palate was revealed. These findings may be of value for unravelling the pathogenesis of palatal clefting.     

Enhanced NO inactivation and hypertension induced by a high-fat, refined-carbohydrate diet

We have recently demonstrated that long-term consumption of a high-fat, refined-carbohydrate (HFS) diet induces hypertension (HTN) in normal rats compared with a low-fat, complex-carbohydrate (LFCC) diet. Limited evidence suggests that high-fat or high-sugar diets cause enhanced generation of reactive oxygen species (ROS). We therefore hypothesized that by inducing oxidative stress, the HFS diet may promote nitric oxide (NO) inactivation and HTN. To test this hypothesis, female Fischer rats were placed on either the HFS or the LFCC diet starting at 2 months of age. Blood pressure, urinary NO metabolites (NO(x)), and total renal NO synthase activity were monitored, and the tissue abundance of nitrotyrosine (NT), which is the stable "footprint" of NO oxidation by ROS, was determined. The HFS diet group exhibited a gradual rise in arterial blood pressure and were hypertensive by 18 months. This trend was accompanied by a marked accumulation of NT in all tested tissues, an initial rise and a subsequent fall in NO synthase activity, and a fall in urinary NO(x) excretion. The HFS diet-fed animals had a blunted blood pressure response to the NO synthase inhibitor N:(omega)-nitro-L-arginine methyl ester (L-NAME) compared with the LFCC diet group, which showed a marked hypertensive response to L-NAME. L-NAME-induced HTN was reversible with L-arginine in the LFCC diet group; however, HTN was not corrected by L-arginine supplementation in the HFS diet group. These findings point to enhanced ROS-mediated inactivation and sequestration of NO, which may contribute to the reduction of bioactive NO and HTN in the HFS diet-fed animals.     

Laryngeal papillomas: the epidemiology in a Danish subpopulation 1965–1984

The incidence rate of laryngeal papillomas in a Danish subpopulation (approximately 2.8 million inhabitants) was 3.84 × 10^-6 per year in the period 1968–1984. For juvenile papillomas the incidence rate was 3.62 × 10^-6, compared with 3.94 × 10^-6 for laryngeal papillomas of adult onset. When comparing different time periods a significantly low incidence was found in the time 1965–1968, while the incidence remained constant in 1969–1984. The low incidence rate in the early period may be real, but selectional bias may have played a part. It is in general anticipated that maternal genital HPV-infections may serve as an HPV-reservoir, and that juvenile laryngeal papilloma is a result of HPV transmission from the mother to the child during birth. In the period in question cervical HPV-infections have been recorded with increasing frequency in younger women, indicating that the prevalence is rising. However, this is not reflected in the incidence of laryngeal papillomas.     

3-D components of a biological neural network visualized in computer generated imagery. II. Macular neural network organization

Computer-assisted reconstructions of small parts of the macular neural network show how the nerve terminals and receptive fields are organized in 3-dimensional space. This biological neural network is anatomically organized for parallel distributed processing of information. Processing appears to be more complex than in computer-based neural networks, because spatiotemporal factors figure into synaptic weighting. Serial reconstruction data show anatomical arrangements which suggest that 1) assemblies of cells analyse and distribute information with inbuilt redundancy, to improve reliability; 2) feedforward/feedback loops provide the capacity for presynaptic modulation of output during processing; 3) constrained randomness in connectivities contributes to adaptability; and 4) local variations in network complexity permit differing analyses of incoming signals to take place simultaneously. The last inference suggests that there may be segregation of information flow to central stations subserving particular functions.