Attempts to isolate virus from human trigeminal and facial ganglions

Herpes virus hominis type 1 was isolated from the trigeminal ganglion (ganglion semilunare, gasservian) in three out of 20 randomly selected autopsies. Two of the three patients had been treated with immunosuppressive or cytostatic agents. Clinical signs of herpes infection were not observed during the previous 6 months. No virus was isolated from the facial ganglion (geniculate ganglion) in the same 20 cases. The findings are discussed in relation to the viral etiology of acute peripheral facial palsy.     

Comparison of the AMPA Antagonist Action of New 2,3-Benzodiazepines in Vitro and Their Neuroprotective Effects in Vivo

PURPOSE: AMPA receptor-mediated excitotoxicity is thought to be a critical process in diseases accompanied by neuronal cell loss following a hypoxic/anoxic state of the central nervous system. It has been suggested that blockade of AMPA receptors might result in significant protection of neurons against cellular damage. For testing the hypothesis, in vitro efficacy and in vivo neuroprotective action of new 2,3-benzodiazepine (2,3BDZ) AMPA antagonists have been compared. METHODS: 2.3BDZs were tested on kainate-evoked whole-cell currents in cultured neurons as well as on population spikes (PS) in rat hippocampal slices. Data were correlated with those obtained from the spreading depression (SD) experiments in chicken retina. Compounds were also examined in the gerbil bilateral carotid occlusion model (BCO), where percentage decrease of ischemia-related hypermotility (HM), impaired spatial memory (SA), and hypoxia-induced hippocampal CA1 neuronal cell death (CA1) were evaluated. RESULTS: Certain structural modifications of classical 2,3BDZs resulted in increased in vitro activity and improved in vivo efficacy. In particular, the halogen-substituted compounds EGIS-9879 and EGIS-9883 showed the highest neuroprotective efficacy (84% and 47% protection in CA1, 71% and 82% decrease in HM, respectively; 4 x 5 mg/kg i.p.) in BCO. PS and SD were correlated to the decrease of neuronal loss in the CA1 area. Lack of significant correlation was found between PS and CA1 (r = 0.437, p = 0.079) or SD and CA1 (r = 0.380, p = 0.146). CONCLUSIONS: Several new 2.3BDZ AMPA receptor antagonists have been synthesized at EGIS Pharmaceuticals characterized by remarkable in vitro and corresponding in vivo neuroprotective properties.     

Labiaplasty of the labia minora: patients' indications for pursuing surgery

IntroductionLimited information is available regarding patients’ indication for seeking labiaplasty of the labia minora.AimThe aim of this article is to investigate a patient's indications for seeking labiaplasty of the labia minora.MethodsThis is a retrospective review of the medical records of all patients undergoing labiaplasty at our clinic over a 27-month period.Main Outcome MeasuresIndications for surgery were assessed using standardized questionnaires during the patients’ initial history and physical. Patients were divided into three groups as based on the questionnaire, including: Group I—patients seeking the procedure strictly for aesthetic reasons; Group II—patients seeking the procedure strictly for functional impairment (i.e., pain and discomfort); and Group III—patients who feel they are having the surgery for both aesthetic and functional reasons. Patients undergoing the surgery for aesthetic reasons were also asked whether this was strictly a personal decision or was influenced by either another man or woman whether a friend, spouse, or partner.ResultsThe review revealed 131 patients had undergone a labia reduction surgery: Group I—those who received labia reduction surgery for strictly aesthetic reasons equaled 37% (49/131); Group II—those seeking the surgery strictly for functional impairment equaled 32% (42/131); and Group III—those seeking the surgery for both functional and aesthetic reasons equaled 31% (40/131).ConclusionThe majority of patients undergoing reduction of the labia minora do so for functional reasons with minimal outside influences affecting their decision for treatment. Miklos JR, and Moore RD. Labiaplasty of the labia minora: Patients's indications for pursuing surgery.     

Right Ventricular Involvement of an Aggressive Malignant Peripheral Nerve Sheath Tumor

We present a case of a 58-year-old woman who had a painful right thigh mass for a few months. A transthoracic echocardiogram revealed no evidence of an intracardiac mass. She had a whole-body positron emission tomography/computed tomography scan two months later that revealed masses in her right lower extremity and a mass in her right ventricle that had not been initially reported. She had been initially diagnosed with an undifferentiated pleomorphic sarcoma, but this diagnosis was changed to a malignant peripheral nerve sheath tumor with repeat pathology. She was subsequently hospitalized. An echocardiogram showed a mass covering 80% of her right ventricle (RV). Serial cardiac magnetic resonance imaging revealed a 9.4 × 5.6 cm RV mass with vascular and avascular portions and inflow and outflow tract obstruction. Computed tomography showed no other metastases. Due to a delay in diagnosis and a decline in left ventricular ejection fraction, the patient could not undergo palliative chemotherapy or radiotherapy     

Repeat Tension-Free Transvaginal Tape (TVT) Sling for the Treatment of Recurrent Stress Urinary Incontinence

The pubovaginal sling is one of the preferred procedures for the treatment of female stress urinary incontinence because of its improved long-term cure rates. Recently a modified technique of the pubovaginal sling, known as the tension-free transvaginal tape (TVT), has gained popularity. We present the first reported cases of repeat TVT pubovaginal sling for the treatment of patients with recurrent stress urinary incontinence. Both patients had repeat TVT slings performed between 6 and 9 months following the initial procedure without revision or removal of the previous TVT sling. Both patients reported surgical cure without significant intraoperative or postoperative complications. It appears that reapplication of the TVT polypropolene sling may be a viable option in the event of initial TVT sling failure.     

Levatorplasty Release and Reconstruction of Rectovaginal Septum using Allogenic Dermal Graft

The goal of reconstructive vaginal surgery include: restoration of normal anatomy, as well as maintaining visceral and sexual function. Rectocele repair can be performed utilizing a number of techniques, however some of these techniques severely distort the posterior vaginal wall anatomy and subsequently may result in dyspareunia. We report two patients with postoperative dyspareunia following levatorplasty technique for the treatment of rectocele. The patients elected to have their levatorplasty released and their rectovaginal septum reconstructed utilizing allogenic dermal graft. Postoperatively both patients are sexually active without evidence of dyspareunia or rectocele.     

Electrode manipulation automatism during temporal lobe seizures.

OBJECTIVE: To describe clinical characteristics and lateralizing value of peri-ictal electrode manipulation automatism (EMA) in patients with temporal lobe epilepsy (TLE) and compare our data with ictal manual automatisms described in the literature. METHODS: Two-hundred and five videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed and EMA (tugging, scratching or adjusting the electrodes and cables) were monitored. RESULTS: Twenty-eight (51%) patients showed EMA during 47 (23%) seizures. Ictal start was noted in 22 seizures and in 19/22 cases EMA finished before the end of seizure. Ictal EMAs were always associated with automotor seizure components. During 25 seizures, exclusively postictal EMAs were observed. Electrode manipulation was presented during 24/112 left-sided and 23/93 right-sided seizures (p = 0.742). Peri-ictal EMA was unilateral (completed by one hand) in 24/47 seizures (10 ictal, 14 postictal); it was done by the hand ipsilateral to the seizure onset zone in 17/24 and by contralateral hand in 7/24 cases (p = 0.064). We observed concomitant contralateral dystonic posturing during 3/10 seizures with unilateral ictal EMA. Unilateral hand automatism, temporally independent from the EMA appeared in 30 (64%) of the 47 seizures. CONCLUSION: Peri-ictal EMA is a frequent phenomenon but shows no lateralizing value in TLE. The mechanism of EMA is in many ways dissimilar from that of earlier described manual automatisms.     

Can a cysteine challenge assay predict the in vivo behavior of Tc-labeled antibodies?

Recent investigations have shown that transchelation to cysteine is a principal mode of in vivo instability of ^99mTc-labeled antibodies. In this investigation, a cysteine challenge assay was used to measure the in vitro instability of ^99mTc directly labeled to two IgG antibodies (B72.3 and C110) via two established direct labeling methods employing mercaptoethanol and stannous ion for antibody reduction and by a novel method using glutathione for this purpose. For both antibodies, the greatest instability to cysteine occurred with stannous ion reduction. The stability of glutathione-reduced B72.3 was indistinguishable from mercaptoethanol-reduced B72.3 whereas glutathione-reduced C110 showed stability roughly intermediate between that of the other reducing agents for this antibody. Results obtained in normal mice were in the direction predicted by the assay: for both antibodies, urinary clearance of ^99mTc was fastest in mice receiving antibodies labeled via stannous ion reduction, presumably because of the increased transchelation of label to cysteine in vivo. Urinary clearance was slower and identical in mice receiving B72.3 labeled via glutathione or mercaptoethanol whereas clearance in the case of glutathione-reduced C110 was intermediate between that of the other two reducing agents. At both time points, higher radioactivity levels were observed in kidneys and lower levels in blood and most other tissues for both antibodies in the case of stannous ion reduction as expected for the label of greatest instability. In the B72.3 case, with only one exception, tissue and blood levels following administration of glutathione-reduced antibody were indistinguishable from that following administration of mercaptoethanol-reduced antibody. In the C110 case, significant differences in activity levels were observed in several tissues between glutathione- and mercaptoethanol-reduced antibodies. In conclusion, the relative in vivo behaviour of ^99mTc when administered to mice while labeled to two IgG antibodies were successfully predicted based on the results of an in vitro cysteine challenge assay.