Comparison of the accuracy of working casts made by the direct and transfer coping procedures.

STATEMENT OF PROBLEM: A working cast with dies that accurately record the prepared abutments, surrounding soft tissues, and adjacent and opposing teeth is necessary. PURPOSE: This study compared the accuracy of the direct and transfer coping methods in recording the vertical and horizontal dimensional relationship of a pair of removable dies in a working cast before and after separation from the stone base. Among the procedures used for making impressions of abutments for fixed partial dentures, the transfer coping procedure has specific advantages. In particular, where there are multiple abutments, this procedure, in which individual impressions are made of the abutments, transfer copings are made, and a transfer impression of the copings is used for seating the dies and fabrication of a dental stone base, is useful. METHODS: Two groups of working casts were fabricated from a stone master cast containing 2 ivorine teeth to simulate abutments. The first group of working casts was fabricated directly from the elastomeric impression of the abutments using a 2-pour procedure. The second group of working casts was made using the transfer coping procedure. RESULTS: When the interdie dimensions in each group were compared with that of the master cast, after separation and replacement of the dies in the stone base, the differences were less than 100 microm and similar for both the direct and transfer coping techniques. CONCLUSIONS: These findings show that either procedure is equally effective in positioning the dies in the working casts.

[Occult gastrointestinal hemorrhage. Description of a case with unusual clinical presentation]. / Emorragie gastro-intestinali di origine sconosciuta. Descrizione di un caso con presentazione clinica anomala.

Bleeding from small bowel is a quite rare event and often is a diagnostic challenge to physician and surgeon. We present a case of a patient with an acute massive haemorrhage due to jejunal diverticulosis and with an unusual clinical setting. The site of bleeding was localized by scan with radiotagged erythrocytes, but the diagnosis of jejunal diverticule was evident only at laparotomy. The patient underwent to surgical resection of the affected bowel (40 cm). Although jejunal diverticula are considered a rare source of gastrointestinal haemorrhage, we suggest that this disorder must be considered in all patients with occult gastrointestinal bleeding especially in the elderly.

A pilot study on the effectiveness of cyclosporine in type II mixed cryoglobulinemia.

OBJECTIVE: To evaluate the effect of cyclosporine in the treatment of type II mixed cryoglobulinemia, after the failure of more conventional therapies. METHODS: Two patients with type II mixed cryoglobulinemia associated with chronic HCV infection, purpura, liver disease, and sensitive/motor neuropathy were treated with cyclosporine (2.5 mg/Kg/b.w.), after their failure to respond to treatment with corticosteroid, immunosuppressive drugs, interferon, and plasmapheresis. RESULTS: In both patients an improvement in the clinical manifestations (purpura and peripheral neuropathy), laboratory results (serum transaminases and cryocrit), and liver histology was seen, as well as the disappearance of bone marrow B-cell lymphoproliferation. CONCLUSION: Cyclosporine may be useful in the treatment of type II mixed cryoglobulinemia with prominent autoimmune clinical manifestations, although further studies are needed to better define the selection of patients.

[Anti-GOR antibodies in type II mixed cryoglobulinemia associated with hepatitis C virus infection]. / Anticorpi anti-GOR nella crioglobulinemia mista tipo II associata a infezione da virus dell' epatite C.

The frequent association of chronic hepatitic C virus (HCV) infection and type II mixed cryoglobulinemia is considered to be one of the possible signs of interaction between the virus and the immune system. This could also be the case for the appearance of anti-GOR antibodies in serum, as they react with both viral and host antigens. We studied a group of patients with chronic hepatitis C infection and a group with type II mixed cryoglobulinemia associated with HCV infection to ascertain if anti-GOR or other non-organ specific autoantibodies were present in the serum. We found no significant difference between the two groups in presence, prevalence or titer of anti-GOR or other autoantibodies. Moreover, the expression of anti-GOR does not seem to influence the severity of liver damage. Our data support the hypothesis that anti-GOR antibodies are a simple expression of molecular mimicry between viral and human epitopes.

Parenchymal renal involvement in three cases of non-Hodgkin lymphomas: clinical and pathological features.

Parenchymal neoplastic invasion of the kidneys is a common postmortem finding in patients who have died from advanced non Hodgkin's lymphomas (NHL). However, it rarely causes major clinical consequences, such as impairment of glomerular and tubular function, acute or rapidly progressive renal failure. Renal involvement is even less frequent as a first manifestation of NHL, the so-called "primary" renal lymphoma. A review of the main clinical, diagnostic and pathological aspects of three cases observed in our division is presented here.

Acute cholestatic hepatitis during simvastatin administration.

Simvastatin, recently introduced in clinical practice for pharmacological treatment of hypercholesterolemia, has been found to cause minor and reversible elevations of serum transaminases. We report a case of acute cholestatic hepatitis during simvastatin therapy. Clinical, biochemical, immunological, and histological findings were consistent with a simvastatin-induced liver damage through an immunological-mediated mechanism. This case suggests a careful monitoring of liver function tests during simvastatin therapy, and caution in continuing simvastatin administration when elevations of serum transaminases take place.

[Behçet's disease. I. Clinical and histopathological aspects]. / La malattia di Behçet. Nota I. Aspetti clinici ed istopatologici.

Behçet disease is characterised by a triple symptom picture (genital and oral aphthae, ocular lesions) named after the Turkish dermatologist, Hulusi Behçet. It is found all over the world, but is particularly frequent in Japan and the Mediterranean basin. Adult males are primarily affected. The classic symptomatological triad may be accompanied by other manifestations involving the skin (hypersensitivity to microtrauma is a peculiar feature), joints, nervous system, gastroenteric system, cardiovascular system (phlebitis, phlebothrombosis), lungs and kidneys. There is a chronic course marked by periods of exacerbation and remission, which may last for years. Diagnosis is clinical only, since neither the laboratory data nor the histopathological signs of vasculitis are truly pathognomonic. The prognosis quoad valetudinem is uncertain with regard to the eye lesions, which may result in blindness. The prognosis quoad vitam is usually good, though it is poor if the nervous system is involved, or in the event of lung and large vessel lesions, since death may occur from haemoptysis or the rupture of aneurysms.

[Behçet's disease. II. Etiopathogenetic and therapeutic aspects. Personal observations]. / La malattia di Behcet. Nota II. Aspetti etiopatogenetici e terapeutici. Osservazioni personali.

The aetiopathogenesis of Behcet's disease is still not known. In the light of current knowledge, the most likely hypothesis seems to be that of an autoimmune reaction set off by viral, bacterial or other antigens. The reaction may manifest itself in the vascular system, and cause vasculitic conditions in genetically susceptible subjects. The existence of a constitutional susceptibility factor would seem to be confirmed by the high and significant incidence of determinant histocompatibility antigens: HLA-B5 in Japan and in Mediterranean countries, HLA-A2 and HLA-A28 in Great Britain and the United States. Corticosteroids are most commonly used to treat the disease; immunosuppressants are also recommended--possibly in association with corticosteroids. Three personally observed cases of Behcet's disease are reported. The first was an example of the disease in its complete form (oral and genital aphthae, ocular lesions); the second case incomplete (no genital aphthae); and the third characterised by severe neurological involvement (neuro-Behcet).