Autism spectrum disorder and paediatric dentistry: A narrative overview of intervention strategy and introduction of an innovative technological intervention method.

AIM: When treating patients with Autism Spectrum Disorder (ASD) the doctor-patient relationship can be very challenging. The dentist is often forced to work under general anaesthesia or conscious sedation. Children with ASD are patients with an increased risk of caries due to poor oral hygiene, a cariogenic diet and the use of xerostomal drugs. In this work therapeutic strategies used to treat this kind of patients are evaluated and a new method to treat children with ASD is presented in order to increase awareness about this condition in the dental field. METHODS: The Atlas Center (a non-profit organisation in Peurgia, Italy) has developed a software, called paINTeraction, that allows these special children to immerse themselves in a virtual reality with the help of an operator. Through this system the child can explore the dental office (and all its sounds and noises) before the real dental visit, thus connecting to the dental professional, achieving greater compliance and reducing anxiety. CONCLUSION: paINTeraction, with the use of digital technology tools, may be particularly well suited to introduce patients to the therapeutic environment, particularly in the dental setting.

Unraveling wetting transition through surface textures with X-rays: liquid meniscus penetration phenomena.

In this report we show that synchrotron X-ray radiography is a powerful method to study liquid-air interface penetration through opaque microtextured surface roughness, leading to wetting transition. We investigate this wetting phenomenon in the context of sessile drop evaporation, and establish that liquid interface sinking into the surface texture is indeed dictated by the balance of capillary and Laplace pressures, where the intrinsically three-dimensional nature of the meniscus must be accounted for. Air bubble entrapment in the texture underneath impacting water drops is also visualized and the mechanisms of post-impact drop evaporation are discussed.

Drop rebound after impact: the role of the receding contact angle.

Data from the literature suggest that the rebound of a drop from a surface can be achieved when the wettability is low, i.e., when contact angles, measured at the triple line (solid-liquid-air), are high. However, no clear criterion exists to predict when a drop will rebound from a surface and which is the key wetting parameter to govern drop rebound (e.g., the "equilibrium" contact angle, θeq, the advancing and the receding contact angles, θA and θR, respectively, the contact angle hysteresis, Δθ, or any combination of these parameters). To clarify the conditions for drop rebound, we conducted experimental tests on different dry solid surfaces with variable wettability, from hydrophobic to superhydrophobic surfaces, with advancing contact angles 108° < θA < 169° and receding contact angles 89° < θR < 161°. It was found that the receding contact angle is the key wetting parameter that influences drop rebound, along with surface hydrophobicity: for the investigated impact conditions (drop diameter 2.4 < D0 < 2.6 mm, impact speed 0.8 < V < 4.1 m/s, Weber number 25 < We < 585), rebound was observed only on surfaces with receding contact angles higher than 100°. Also, the drop rebound time decreased by increasing the receding contact angle. It was also shown that in general care must be taken when using statically defined wetting parameters (such as advancing and receding contact angles) to predict the dynamic behavior of a liquid on a solid surface because the dynamics of the phenomenon may affect surface wetting close to the impact point (e.g., as a result of the transition from the Cassie-Baxter to Wenzel state in the case of the so-called superhydrophobic surfaces) and thus affect the drop rebound.

Water drops dancing on ice: how sublimation leads to drop rebound.

Drop rebound is a spectacular event that appears after impact on hydrophobic or superhydrophobic surfaces but can also be induced through the so-called Leidenfrost effect. Here we demonstrate that drop rebound can also originate from another physical phenomenon, the solid substrate sublimation. Through drop impact experiments on a superhydrophobic surface, a hot plate, and solid carbon dioxide (commonly known as dry ice), we compare drop rebound based on three different physical mechanisms, which apparently share nothing in common (superhydrophobicity, evaporation, and sublimation), but lead to the same rebound phenomenon in an extremely wide temperature range, from 300 °C down to even below -79 °C. The formation and unprecedented visualization of an air vortex ring around an impacting drop are also reported.

General methodology for evaluating the adhesion force of drops and bubbles on solid surfaces.

The shortcomings of the current formulation for calculating the adhesion force for drops and bubbles with noncircular contact lines are discussed. A general formulation to evaluate the adhesion force due to surface forces is presented. Also, a novel methodology, that is, IBAFA, image based adhesion force analysis, was developed to allow implementation of the general formulation. IBAFA is based on the use of multiple profile images of a drop. The images are analyzed (1) to accurately reconstruct the contact line shape, which is analytically represented by a Fourier cosine series, and (2) to measure contact angles at multiple locations along the contact line and determine the contact angle distribution based on a linear piecewise interpolation routine. The contact line shape reconstruction procedure was validated with both actual experiments and simulated experiments. The procedure for the evaluation of the adhesion force was tested using simulated experiments with synthetic drops of known shapes. A comparison with current methods showed that simplifying assumptions (e.g., elliptical contact line or linear contact angle distribution) used in these methods result in errors up to 76% in the estimated adhesion force. However, the drop adhesion force evaluated using IBAFA results in small errors on the order of 1%.

In vivo mechanical and in vitro electromagnetic side-effects of a ruminal transponder in cattle.

This work was undertaken to assess the long-term impacts of a ruminal transponder, used for electronic identification, on ruminal motility and on health and performance of cattle, as well as to study the electromagnetic effects on ruminal bacteria in vitro. A passive transponder (51.4 g, 67 x 17 mm) was delivered into the forestomachs of 8 calves, 32 bulls, 10 heifers, and 40 dairy cows. Final readability was 87.5% in calves, 96.9% in bulls, 90% in heifers, and 100% in cows at 481, 360, 650, and 601 d, respectively, after transponder administration. The transponder did not affect production or reproduction of cows over a 2-yr period, or performance of bulls, or mortality compared with control animals. Chewing movements per bolus were lower (P <0.01) in treated animals than in controls (49.6 vs. 52.2, 51.2 vs. 63.6, and 57.0 vs. 59.7 for bulls, heifers, and cows, respectively). Regurgitation frequency (number of boluses/10 min) tended to be greater in treated cattle: 12.4 vs. 11.3 (P = 0.07), 11.3 vs. 10.6, and 11.3 vs. 10.7 (P = 0.08) for bulls, heifers, and cows, respectively. Rumination patterns of calves fitted with transponders within the first weeks of life were similar to controls. During the experiment, 43 treated animals (8 calves, 29 bulls, and 6 cows) were slaughtered. Thirty transponders were localized in the reticulum (3 calves, 24 bulls, and 3 cows), 11 in the rumen (4 calves, 4 bulls, and 3 cows), and 2 were not recovered (1 calf and 1 bull). Within the calves, 57% of the boluses were found in the rumen. In 8 reticula (2 calves and 6 bulls) and 1 rumen (1 cow), an impression left by physical contact of the transponder was observed, although histological examination did not reveal specific lesions in the mucosa of the dystrophic areas. In strained, whole ruminal contents incubated in vitro, pH values were lower after 24 and 48 h (P <0.001) of continuous exposure to an electromagnetic field induced by the transponder-reading system. After 48 h of incubation, total bacterial numbers and NH3-N concentration were greater (P <0.001) in exposed flasks than in controls. These data indicate that the transponder may alter, via mechanical action, the reticuloruminal mucosa and rumination patterns. Furthermore, the transponder may increase, via its electromagnetic action, the growth rate and metabolic activity of ruminal bacteria.

[Postoperative pneumonia caused by Candida in 500 lung surgery patients]. / Le polmoniti da Candida in 500 interventi di resezione polmonare.

BACKGROUND: Postoperative infections continue to be one of the most frequent complications in hospitalized patients. The incidence of fungal infection has been steadily rising. While Candida albicans remains the most common yeast species isolated in hospitalized patients, other Candida species have been increasingly isolated. METHODS: From 1996 to 2001, a prospective study of 500 consecutive lung surgery patients treated by the same surgical team was conducted to monitor the number of postoperative infections and to evaluate the epidemiology of bacterial and fungal infections. RESULTS: At least one postoperative infection developed in 18% of patients. Of the 51 patients who developed postoperative pneumonia, 24 underwent microbiological examination of sputum. In 19 of them, the culture yielded isolates of one or more Candida species. Slightly under half of patients (47%) with cultures positive for mycetes received treatment with fluconazole until the clinical infection resolved. The drug was well tolerated by all treated patients. CONCLUSIONS: The incidence of fungal infection has increased also at our center. In 19 of 24 patients with postoperative pneumonia, sputum cultures yielded Candida species isolates. Many factors may be contributing to the rise in fungal infections after surgery. As pneumonia caused by Candida led to a significantly longer length of hospital stay in our case series, we draw attention to the importance of early diagnosis of postoperative mycotic lung disease in order to institute timely and targeted therapy.

[Fallopian tube adenocarcinoma: synchronous neoplasia and severe uterine endocervical squamous epithelial dysplasia]. / Adenocarcinoma della tuba di Fallopio: neoplasia sincrona a displasia epiteliale squamosa severa endocervicale uterina.

We report a rare case of primary carcinoma of the fallopian tube. A 72-year-old post-menopausal woman presenting with abnormal secretion of blood-stained liquid, underwent surgery because of findings of atypical squamous cells (ASCUS) on a routine Papanicolaou smear. The histological diagnosis on cervical biopsy was of CIN 3. Adenocarcinoma of the Fallopian tube was incidentally found.

Long-term results of penile vein ligation for erectile dysfunction due to cavernovenous disease.

PURPOSE: We now know that outflow restriction is essential for maintaining a rigid erection, which can be achieved after satisfactory smooth muscle relaxation. The aim of this study was to assess retrospectively the efficacy of penile vein surgical ligation in patients with a follow-up of at least 3 years. MATERIALS AND METHODS: Thirty-two men with impotence due to cavernovenous occlusive disease underwent penile vein ligation for management of organic erectile dysfunction. Cavernovenous occlusive disease was diagnosed by gravity cavernosometry. RESULTS: Long-term evaluation revealed sustained potency without adjunctive therapy in only 7 patients (21.87%). Twenty-five patients (78.12%) did not show any improvement in the erectile mechanism. Associated complications included penile shortening in 4 (12.5%), hypoesthesia of the glans area in 2 (6.25%), and Peyronie's disease in 1 (3.2%). CONCLUSION: Based on these data, we conclude that the long-term success of penile vein ligation is poor.

Isolated brain metastasis of malignant choroidal melanoma 27 years after enucleation.

Choroidal melanoma primarily metastasizes to the liver. Isolated extrahepatic metastases have rarely been reported and they generally resulted in death within 6 months. We describe a patient who developed an isolated brain metastasis 27 years after his left eye was enucleated for choroidal melanoma. The metastasis was successfully treated with surgery and radiotherapy. The patient is alive and disease free 3 years after treatment of the metastasis. Posterior location and other clinical and morphologic characteristics of primary choroidal melanoma could explain the unusually long latency of this solitary extrahepatic metastatic disease. Lifelong surveillance to detect early signs of metastasis is mandatory for any patient treated for choroidal melanoma.

[Stromal tumor of the ileum (GIST) at the same time as a renal carcinoma. Description of a case and review of the literature]. / Tumore stromale dell'ileo (GIST) sincrono a carcinoma renale. Descrizione di un caso e revisione della letteratura.

The gastrointestinal mesenchymal tumors from a heterogenous group that include several entities: leiomyomas, schwanomas and less differentiated tumors often referred as GIST. These neoplasm are uncommon and their clinical behaviour is most difficult to predict. We describe a malignant gastrointestinal stromal tumor of the ileum coexisting with renal cell carcinoma. The neoplasms were fixed in formaldehyde, embedded in paraffin and stained with hematoxylin-eosin. For immunohistochemical studies deparaffinized tissue sections were incubated with antibodies against vimentin, desmin, muscle specific actin, S100, CD34, GFAP, NSE and keratin. The epithelioid and spindle cells of ileal neoplasm were arranged in interlacing fascicle with occasional palisading and were positive for vimentin and CD34. Positivity for muscle specific actin was focally found. The renal neoplasm required differential diagnosis from metastatic GIST. The morphological and immunohistochemical investigations in our case were consistent with GIST coexisting with primitive renal cell carcinoma. One of the problems connected to the anatomo-clinical evaluation of GIST consist in the difficulty of making a prognosis. An almost complete review of the literature and view point on the topic has been performed. As a conclusion judging from papers regarding this argument, no clear parameters of biological behaviour exist excluding mitotic index.

Porocarcinoma detected by fine needle aspiration biopsy of a node metastasis. A case report.

BACKGROUND: Porocarcinomas were first reported by Pinkus and Meherengan in 1963 as uncommon malignant adnexal tumors of the skin characterized by epidermotropism with pagetoid diffusion within the epidermis. CASE: The cytologic findings of an eccrine porocarcinoma lymph node metastasis in a 65-year-old female and histologic features of the skin recurrence are reported. Metastasis was firstly identified by fine needle aspiration biopsy (FNAB) performed on one inguinal lymph node. Cytologically the tumor was characterized by atypical malignant cells showing clear granular or keratinized cytoplasm and vesicular nuclei, with prominent nucleoli, which were irregularly dispersed or forming nests or cords, sometimes harboring central necrosis. The skin metastasis, detected after the cytologic FNAB diagnosis, showed superficial dissemination within the epidermis and dermal invasion. CONCLUSION: Cytologic diagnosis of porocarcinoma metastases by FNAB is important for adequate treatment, but adherence to strict diagnostic criteria is necessary. The tumor cells could be histogenetically related to the intraepidermal duct cells of the eccrine sweat glands, and pagetoid diffusion is considered a sort of homing phenomenon.

[Hepatoid adenocarcinoma of the stomach. Case report and review of the literature]. / Adenocarcinoma epatoide dello stomaco. Osservazione di un caso e revisione della letteratura.

Hepatoid adenocarcinoma of the stomach is an uncommon gastric tumor. A throughout search of the literature revealed only 86 cases: the first case was reported by Bourreille et al in 1970. We describe a patient with primary gastric adenocarcinoma with high serum alpha-fetoprotein (AFP) levels (7000 ng/ml). Histologically foci strongly resembling hepatocellular carcinoma with hyaline globules were noted. Immunoreactivity for alpha-fetoprotein (AFP), a1 antitrypsin and CEA also indicate hepatocellular differentiation. This case provides informations on the DNA content and Ki67 expression of this unusual and aggressive variant of gastric adenocarcinoma.

[Up-date on acute ischemia of the limbs]. / Aggiornamenti in tema di ischemia acuta degli arti.

The authors report their experience in the treatment of acute ischemia of the limbs during the last year. They underline the importance of a right diagnostic and therapeutic treatment particularly in a little hospital, as reported in an algorytm published recently in the literature. They analyze 11 patients, one of them with an embolism of the arm, with a different degree of ischemia. The results are similar to those reported in the literature.

[Acute intestinal ischemia. Review of the literature and personal experience]. / Ischemia intestinale acuta. Revisione della letteratura ed esperienza personale.

The authors report the experience of their surgical department in the diagnosis and treatment of acute arterial mesenteric ischaemia. Their results are similar to those of the literature. Stress is laid on early diagnosis and interest of mesenteric angiography, laparoscopy and color flow ultrasound. Arterial revascularisation must be the surgical aim but the prognosis of acute mesenteric ischaemia remains very severe.

Carcinosarcoma of penis. Case report and review of the literature.

AIMS OF THE STUDY: Carcinosarcomas (sarcomatoid carcinomas) are controversial, biphasic tumors composed of both carcinomatous and sarcomatous elements. They are uncommon and occur in numerous locations. At the time of this report only 3 cases of carcinosarcoma of penis have been reported in the literature. The aim of this article is to provide a discussion of these lesions, using informations gleaned from the pertinent literature as well as the personal experience of the authors. METHODS: The formalin-fixed paraffin-embedded tissue was stained with hematoxylin and eosin, reticulum, alcian blue and Mallory's trichrome stains. Section from selected paraffin-embedded blocks, were stained with antibodies to citokeratins, EMA, vimentin, desmin, and a actin. RESULTS: In our case the carcinomatous elements were admixed with areas of "divergent differentiation": spindle-cell and giant-cell sarcomatoid component with bone and cartilage differentiation were noted. In situ carcinoma was also detected. Immunohistochemistry showed reactivity for keratin and epithelial membrane antigen (EMA). In most of pleomorphic spindle elements. Immunoreactivity for vimentin, desmin and actin were focally found. CONCLUSIONS: The carcinosarcomas may demonstrate "divergent" differentiation into bone, cartilage or myogenous tissue, so it is possible that the cell of origin could be heterogeneous. In our case myogenous differentiation was focally found. Although the clinical data, available from the only three cases of the literature, demonstrate that the behaviour of this tumors was not different from those of squamous cell carcinoma, the authors recommended a constant careful follow-up of the patients.

Ovarian teratomas. An analysis of 134 cases.

All ovarian teratomas observed from 1979 to 1989 in the Institute of Pathology University of Padua are revised. Mature and immature teratomas are analyzed separately because of their different prognoses.

Combined granular cell tumour of the oesophagus and stomach: a case report and review of the literature.

The case of a 56-year-old man with contemporary benign granular cell tumour of the oesophagus and stomach is reported. Surgical resection of the oesophagus and stomach was performed after the diagnosis of squamous cell carcinoma on a superficial oesophageal biopsy which showed a pseudo-epitheliomatous hyperplasia of the stratified squamous epithelium covering the oesophageal Granular Cell Tumour (GCT). Hyperplasia was also found in the overlying gastric mucosa. Eight GCTs of the oesophagus, observed between 1980 and 1985, were reevaluated to compare the neoplastic characteristics and the occurrence of overlying epithelial hyperplasia. Only one patient was female; three had multiple oesophageal tumours and four showed pseudo-epitheliomatous hyperplasia. A review of the literature is included with emphasis on the rare cases of multiple GCTs. The association of chronic alcoholism with GCT of the gastro-intestinal tract is also stressed.

Effect of plasma exchange in a patient with prolonged deep coma from thrombotic thrombocytopenic purpura.

The clinical, laboratory and instrumental data of a patient with thrombotic thrombocytopenic purpura (TTP) are reported in detail, with reference to an articulated therapeutic regimen including plasma exchange, high-dose methylprednisolone and dipiridamole. Particular emphasis is placed on the dramatic improvement obtained with this treatment despite a very delayed diagnosis and prolonged, severe neurological involvement. A short discussion and review of the literature concerning the role of plasma-exchange in the treatment of TTP is reported.