Diencephalic syndrome following cervical spinal cord trauma

Summary The authors discuss about five cases of diabetes insipidus observed in patients affected by traumatic cervical spine fractures and/ or dislocations, without either evident lesions of the cerebral structures at CT scan examination, or important craniocerebral trauma.In all patients polyuria and hyperthermia arose some days after the traumatic accident and regressed spontaneously or after exogeneous vasopressin administration.Vasopressin urinary levels confirmed the presence of a true diabetes insipidus, the origin of which is in largely obscure. A central medullary vasopressin mediated pathway, demonstrated only in experimental animals, may be responsible for such a finding.     

Percutaneous glossopharyngeal thermocoagulation complicated by syncope and seizures

We describe the case of a patient who, during the percutaneous thermocoagulation of the petrous ganglion of Andersch, suffered a serious vagal response resulting in cardiac arrest, collapse, and generalized convulsions. Notwithstanding such major symptoms, the postoperative examination revealed no lesions of the vagus nerve and the glossopharyngeal lesion was shown to be isolated and selective.     

Aqueductal stenosis following mumps virus infection. Case report

A case of aqueductal stenosis following mumps infection is reported, to the authors' knowledge the 12^th case in the literature. The pathogenetic events are discussed and the literature reviewed.

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Sommario È riportato un caso di stenosi dell'acquedotto a seguito di una infezione parotitica. Questo rappresenta il 12° caso della letteratura a conoscenza degli autori. Gli eventi patogenetici vengono discussi alla luce della letteratura.

     

Evaluation of endorphin content in the CSF of patients with trigeminal neuralgia before and after Gasserian ganglion thermocoagulation

The beta-endorphin content in cerebrospinal fluid (CSF) was evaluated in 10 patients with idiopathic trigeminal neuralgia during medical treatment (with or without carbamazepine) and after selective thermocoagulation of the Gasserian ganglion. These values were compared with those obtained in a control group of seven patients without pain problems. No statistically significant difference was found between patients suffering from trigeminal neuralgia and those without pain. Furthermore, neither pharmacological treatment nor surgery changed CSF endorphin values. It is concluded that there is no pathogenetic relationship between trigeminal neuralgia and endorphins.     

Comparison of metal release from new and recycled bracket-archwire combinations

Most orthodontic brackets and archwires made from stainless steel or nickel (Ni)-titanium (Ti) alloys can release metal ions into the saliva. This study measures the amounts of metal released from simulated fixed orthodontic appliances. Sixty simulated fixed orthodontic appliances were manufactured in different ways and divided into four equal groups as follows: new brackets and new archwires (group 1 controls), new brackets and recycled archwires (group 2), recycled brackets and new archwires (group 3), and recycled brackets and recycled archwires (group 4). The bracket bases coated with adhesives were heated at 350 degrees C for 30 minutes. Recycled archwires were sterilized by autoclaving. Each appliance was soaked in artificial saliva of pH 7 at 37 degrees C for 45 days. At the end of this period, a sample of the artificial saliva was collected for analysis. Concentrations of Ni, chromium (Cr), iron (Fe), manganese, copper (Cu), and Ti ions were measured by atomic absorption and recorded in micrograms per liter. Analysis of variance and the Duncan multiple-range test indicated significant differences among the groups (P < .001). The study revealed the following: (1) group 4 released higher amounts of Cr, Fe, and Ti than any of the other three combinations; (2) Ni release was similar in groups 1 and 2 and in groups 2, 3, and 4; (3) the amounts of Cu, Cr, and Ti ions released from groups 3 and 4 were significantly greater than the amounts released from the other two combinations.     

Pain on injection of propofol: a comparison of methylene blue and lidocaine

Study Objective

To investigate whether methylene blue, given before injection of propofol, was effective in reducing the frequency and severity of pain associated with propofol injection.

Design

Prospective, randomized, double-blinded clinical study.

Setting

Operating room of a university hospital.

Patients

90 adult, ASA physical status 1 and 2 patients undergoing elective surgery.

Interventions

Patients were randomly allocated to one of three groups of 30 patients each. Group I received 50 mg of methylene blue, Group II received 40 mg of lidocaine, and Group III, the control group, was given normal saline. All drugs were given as a 2.0 mL bolus 45 seconds before propofol administration.

Measurements

Injection pain using vocal responses, facial grimacing, arm withdrawal, tears, and questioning of the patient were noted. A 4-point scale was used for documenting pain.

Main Results

Pain frequency was 90% in the saline group, whereas the frequencies were significantly lower in the lidocaine and methylene blue groups (26.7% and 40%, respectively).

Conclusions

Intravenous pretreatment with methylene blue appears to be effective in reducing the pain during propofol injection.