Infectious hepatitis in a college football player

The diagnosis of infectious hepatitis was made in a football player at East Carolina University in the 3rd week of fall practice in 1974. Clinical and laboratory evaluation of all persons involved in the program followed. All participants received immune serum globulin. No further cases were identified. Serum chemistry and enzyme levels were determined under uncontrolled conditions. Lactate dehydrogenase and alkaline phosphatase were generally elevated.     

Noncontact knee dislocation in a female basketball player: a case report

Knee ligamentous injuries occur during sport, and when there is extensive injury, they can be associated with subluxation or dislocation. We present the case of a female basketball player who sustained a knee dislocation during noncontact play. An immediate angiogram confirmed vascular integrity, and surgical treatment with ligamentous reconstruction was performed. Peroneal nerve injury was present but resolved in 42 weeks. A review of the literature discussing knee dislocation is presented.     

Neuropsychological assessment of the college football player

The application of neuropsychological assessment procedures to the evaluation of athletes has recently become an area of intense interest and debate and has led to the development of research initiatives at both the amateur and the professional level. However, to date, only a handful of research studies have been completed that have addressed the special issues that accompany the use of neuropsychological assessment instruments with athletes. This article reviews the past use of psychological testing in sports and presents a model of neuropsychological assessment that is currently being utilized in the National Football League. In addition, the extension of this approach to major college football is discussed and test-retest data from a sample presented to provide the basis for comparison of athletes who have suffered a concussion. Recommendations of a national panel of neuropsychologists who are involved in the evaluation of athletes are presented in hopes of encouraging new research initiatives in this area.     

Malpositioned endolymphatic subarachnoid shunt causing trigeminal neuralgia: case report

A case is presented of a 64-year-old female with a fifteen year history of right facial pain. The last nine years the facial pain is described as an intense, stabbing pain in the maxillary division of the right trigeminal nerve. The patient had Meniere's Disease for which an endolymphatic subarachnoid shunt was placed fifteen years prior. The patient underwent intensive medical and several surgical therapies for pain. Some of the procedures were initially successful but none provided lasting relief. Because of severe recurrent right facial pain, the patient underwent a right open partial rhizotomy of the trigeminal nerve via a retrosigmoid approach. Intraoperative findings included the end of the endolymphatic subarachnoid shunt in association with the trigeminal nerve roots. The end of the shunt was removed at the time of surgery. Postoperatively the patient has been pain free for thirty months. It is proposed a malpositioned or migrated endolymphatic subarachnoid shunt may be a cause of trigeminal neuralgia.     

Occipital nerve neuralgia as postoperative complication. Views on etiology and treatment

INTRODUCTION: Meta-iodobenzylguanidine (MIBG) in its 131I-labeled form is clinically used as a tumor-targeted radiopharmaceutical in the diagnosis and treatment of adrenergic tumors. This well established drug may have additional clinical applications as a radiosensitizer or hyperthermic agent, ie., MIBG reportedly inhibits mitochondrial respiration in vitro. The mechanism for MIBG inhibition of cellular oxygen consumption is uncertain. Moreover, MIBG reportedly stimulates glycolysis both in vitro and in vivo. Our studies show the effect of MIBG on 9L glioma oxygen consumption and redox status with tumors cells in vitro and in vivo. MATERIALS AND METHODS: The effects on electron transfer were determined by following oxygen consumption with a Clark oxygen electrode. Fluorescence measurements were used to determine effects of MIBG on intracellular electron acceptors, NADPH and flavoproteins, in vitro and in vivo. 31P-NMR was used to determine alterations in tumor cell pH in vivo. RESULTS: Our results show the inhibition of oxygen utilization with MIBG for cell suspensions in vitro. The same results were demonstrated for tumor cell suspensions rapidly isolated from tumors grown in rats. Moreover, NAD(P)H and flavoprotein (Fp) fluorescence changes were observed to rapidly occur following MIBG addition in vitro. Changes in intracellular pH measured with 31P-NMR, in vivo, precede the changes in fluorescence of NAD(P)H and Fp obtained with frozen sections of tumor. CONCLUSIONS: We conclude that 31P-NMR measurements and fluorescence changes, following MIBG injection, can be used as criterion for selecting the proper time to treat tumors with ionizing radiation or hyperthermia.     

Involvement of dental occlusion and trigeminal neuralgia: a clinical report

Over a 12-month period 501 children (age range 11 months to 15 years) underwent surgery for a possible middle ear effusion. All had tympanometry performed within 2 h of surgery. The results of tympanometry were correlated with the surgical findings in 955 ears. A type-B tympanogram has a high sensitivity (0.91) in predicting middle ear effusion with good specificity (0.79). A type-A tympanogram has a very high specificity (0.99) in predicting a dry middle ear but low sensitivity (0.34). Both the positive (0.91) and negative (0.84) predictive values of a type-A tympanogram are high. The addition of a type-C tympanogram increases the sensitivity of predicting a dry middle ear to 0.79. The positive predictive value of a peaked (type-A or -C) tympanogram is 0.71 and should be considered strong evidence that the middle ear is dry. Tympanometry is the best clinical test for the presence or absence of a middle ear effusion, and on the basis of preoperative tympanometry alone the need for surgery should be carefully reassessed.     

Hemangiopericytoma: a case report

We describe one case of hemangiopericytoma touching a 44-year-old man. It is a rare vascular tumor originating from pericytes surrounding capillaries. The main typical features of it are the difficulty in doing an histologic diagnosis and the impossibility to make out a reliable prognosis. The therapy of choice is a surgical procedure sometimes in combination with radio- and/or chemotherapy.     

Pseudopneumoperitoneum: a case report

A case of post-traumatic pseudocyst of the pancreas is presented. The elevated and compressed stomach showed an appearance on X-ray film which might be interpreted as free peritoneal air. The term pseudopneumoperitoneum is defined and other causes of this condition are mentioned.     

Pyomyositis in childhood: a case report

Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.     

Facial pain in a case of cranial dystonia: a case report

A 76-year-old man had shown sustained excruciating facial pain in the maxillary region for more than 30 years. Since he was suffering from blepharospasm, facial electromyography was performed and revealed a perioral dystonia. This possible cause of facial pain might have been overlooked had dystonia not been considered and electromyographical studies performed. Repeated intramuscular perioral injections of botulinum toxin brought about complete pain relief. This case shows that involuntary activity of facial muscles can cause a severe chronic pain syndrome. Possible mechanisms include irritation of ascending trigeminal fibers, muscle ischemia due to compression of blood -vessels, or release of pain-producing substances.     

Intranasal conformers: a case report

This case report describes the clinical and laboratory procedures in treating a patient that was referred to the dental clinic with the chief complaint of difficulty of breathing through his nose. Examination of the patient revealed constricted nostrils as a result of previous surgeries. It was decided that the patient would benefit from construction of intranasal conformers. The conformers were constructed from acrylic resin because of the material's durability, ease of cleaning, esthetics and ability to be hollowed-out to allow for nasal breathing. Alginate molds were used in this case, as this type of mold offers the advantage of being reusable. Although this procedure does not fall within the usual area of dentistry, members of the dental team may, on occasion, be asked for this service.     

Cantrell''s pentalogy: a case report

Nine chemotherapy-naive women with recurrent (2 patients) or high risk factors (bilateral or extraovarian spread, poorly-differentiated tumor, age > or = 40 years at diagnosis, residual disease after surgery) granulosa-cell tumors were treated with cisplatin, cyclophosphamide with or without doxorubicin (PAC, PC) or cisplatin, etoposide and bleamycin (PVP-16B). Toxicity was acceptable and the most frequently encountered adverse reactions were WHO grade 3 gastrointestinal toxicity in 77% of patients, and grade 3 myelosuppression in 22% of cases. Clinical complete response was achieved in the 2 patients with recurrent disease. Five patients underwent second look surgery which documented: complete response in 3 patients, partial response in 1 patient and progressive disease in 1 case. Median survival was 85 months (range 14-103). Cisplatin-based cytotoxic regimens may be of benefit in the treatment of recurrent or high risk granulosa-cell tumors.     

Truncal duplication: a case report

The mechanical properties of fascia lata in the form of a sheet and as a tubulised structure have been determined. The stiffness of the sheet was 3.3 +/- 0.58 N/mm and the stiffness of the tube was 6.2 +/- 1.06 N/mm. The ultimate tensile strength of the tube was 35.7 +/- 14.1 N.     

Sand aspiration: a case report

There have been few documented cases of sand aspiration. The authors report on a 3-year-old boy who suffered severe respiratory compromise secondary to sand aspiration. Emergency intubation and subsequent bronchoscopy were required to relieve airway obstruction. The patient did well and suffered no long-term sequelae.