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.     

CARBAMAZEPINE USE IN AGGRESSIVE BEHAVIOUR ASSOCIATED WITH SENILE DEMENTIA

In a randomized placebo crossover controlled study, six patients meeting DSM-III-R criteria for Alzheimer's disease and exhibiting significantly aggressive behaviour were administered carbamazepine (in doses up to 600 mg daily) and placebo, with each treatment period lasting 8 weeks. Levels of aggression as measured by the RAGE scale were significantly reduced compared with placebo (p<0.05). The results suggest that carbamazepine is an effective anti-aggressive agent in patients with dementia. Recommendations for further studies are made.     

Comparison of static friction with self-ligating,modified slot design and conventional brackets

Objective

To compare the static frictional forces generated at the bracket/wire interface of stainless steel brackets with different geometries and angulations, combined with orthodontic wires of different diameters.

Material and Methods

The frictional forces were evaluated with three different types of metal brackets: a passive self-ligating (SmartClip^TM, 3M/Unitek, Monrovia, USA), with a modified slot design (Mini Uni Twin^TM, 3M/Unitek, Monrovia, USA) and conventional (Kirium, Abzil, São José do Rio Preto, Brazil). The samples were mounted in a testing device with three different angulations and tested with 0.014" and 0.018" stainless steel wires (American Orthodontics, Sheboygan, USA). The static frictional force was measured using a universal testing machine (DL 500, EMIC^®, São José dos Pinhais, Brazil) with a crosshead speed of 1 mm/min. Statistical analysis was performed by two-way ANOVA followed by Bonferroni''s post hoc test.

Results

There was a significant difference (p<0.05) in static friction when the three types of brackets were tested with the same wire size. The wire diameter influenced friction only when the brackets had a 10º angulation (p<0.05). The angulation influenced friction (p<0.05) when the brackets were associated with a 0.018" wire.

Conclusion

Brackets with a modified slot design showed intermediate static frictional force values between the conventional and self-ligating brackets tested.     

ATTEMPTS TO RECOVER HERPES SIMPLEX VIRUS FROM SKIN SITES OF RECURRENT INFECTION

ABSTRACT: We attempted to recover herpes simplex virus from the cutaneous sites of recurrent infections by co-cultivating explants of skin with monolayers of herpes virus susceptible cell lines. We were unable to demonstrate virus in the asymptomatic skin with this technique. Efforts to activate repressed virus in 2 patients by pretreatment of cultures with 5-iodo-2-deoxyuridine and application of the indirect fluorescent antibody technique to skin from 3 patients also failed to reveal evidence of herpesvirus. Our results support the concept that latent herpesvirus resides in nerve tissue but not skin.     

A Family with Hemoglobin I

Hemoglobin I was recently found in a Negro family. The amino acidsubstitution was shown to occur in the sixteenth residue of the chain (lys asp) and to be identical with hemoglobin I described by Murayama.¹⁰ Theminor component, I₂, was demonstrated by agar gel electrophoresis.

Submitted on January 9, 1963 Accepted on April 3, 1963