Bacillary epithelioid angiomatosis involving the liver, spleen, and skin in an AIDS patient with concurrent Kaposi's sarcoma.

The simultaneous findings of bacillary epithelioid angiomatosis and Kaposi's sarcoma of the skin with visceral hepatosplenic bacillary epithelioid angiomatosis is reported in a patient with acquired immune deficiency syndrome. Liver biopsy showed periportal peliotic spindle cell foci that initially were misinterpreted as Kaposi's sarcoma. After antibiotic therapy induced rapid clinical improvement, repeated liver biopsy showed resolution of the previously noted lesions. Although the violaceous skin lesions all appeared similar clinically, some resolved completely and some progressed. One of the latter was biopsied and had the histologic features of Kaposi's sarcoma. The differential diagnosis is discussed.

Heterophil-negative mononucleosis-like illnesses with atypical lymphocytosis in patients undergoing seroconversions to the human immunodeficiency virus.

The authors present data from four patients with acute heterophil-negative mononucleosis-like illnesses who were initially thought to have primary Epstein-Barr virus (EBV) infections but eventually were shown to be seroconverting to the human immunodeficiency virus (HIV). Widespread lymphadenopathy and blood smears indistinguishable from those typically encountered in the acute phase of infectious mononucleosis were present in all cases. There were also varying combinations of fever, sore throat, and malaise, as well as mild abnormalities of hepatic function and elevated cold agglutinins (anti-I). Anti-HIV was detected by both enzyme-linked immunosorbent assay and Western blot techniques in all cases, with increasing titers noted in two of three serially studied cases. In one patient, a dual infection with the hepatitis B virus was also documented. Diagnostic possibilities in patients with acute mononucleosis-like illnesses dominated by prominent lymphadenopathy should include primary seroconversions to HIV.

Radiation carrier for treatment of nasopharyngeal carcinomas.

A technique for intracavitary radiation therapy of nasopharyngeal carcinomas has been presented. This technique includes a direct impression technique of the nasopharynx and fabrication of a silicone carrier to house the radioactive source.

Nasal videoendoscopy in prosthetic management of palatopharyngeal dysfunction.

Application of nasal videoendoscopic procedures simplifies and objectifies design of an obturator prosthesis. Although oral videoendoscopic techniques are also valuable, the nasal perspective provides valuable information not visible from the oral perspective. Because the primary function of the obturator prosthesis is to eliminate hypernasal speech and perceived nasal emission of air associated with palatopharyngeal insufficiency, nasal videoendoscopy should be considered to verify proper soft tissue-obturator contact during speech.

Comparison of compressive strength of solid and hollow pontic designs for ceramometal fixed partial dentures.

A total of 60 ceramometal frameworks were subjected to compressive loading. Half of the specimens had a hollow pontic design. After the addition of porcelain, it was found that there was no significant difference in the fracture resistance of the porcelain whether the pontic was solid or hollow.

A technique for fabrication of a cheek recontouring prosthesis.

A technique has been described for fabrication of a removable prosthesis that restores proper cheek contour. This prosthesis is a modified removable partial denture with a retentive surface to hold an acrylic resin bolus to recontour the cheek from within. The advantages of such a prosthesis for the patient with facial nerve paralysis include restoration of fullness and proper contour to the cheek (Figs. 7 and 8), prevention of trauma to the buccal mucosa during mastication, and stretching of the cheek, which indirectly improves oral hygiene in the buccal sulcus. The disadvantages of this technique include limited improvement in esthetic and functional contour of the cheek, and food accumulation beneath the acrylic resin bolus, which requires more meticulous hygiene.

Dental rehabilitation of the patient with severe caries after radiation therapy.

Dental management of the patient with severe caries after radiation therapy can be accomplished by the general practitioner in an office setting. Because of the decrease in vascularity that results from radiotherapy, the general practitioner must keep the following points in mind when treating these patients: Extraction of teeth that were in the field of radiotherapy is contraindicated. If there is a question about a possible extraction, consultation should be made with the patient's radiotherapist and a hospital-trained dentist (preferably, an oral surgeon). Endodontic treatment is the only treatment indicated for pulpally damaged teeth in the field of radiotherapy. When endodontic treatment is done, the following precautions are necessary: all teeth that are an immediate source of infection must be treated first; prophylactic antibiotics should be administered for the duration of treatment'; all endodontic procedures must be administered in an aseptic field of treatment--if a tooth is badly deteriorated as a result of severe caries, a copper band should be used with a rubber dam and no tooth should ever be left "open for drainage" in these patients; temporary fillings should be of sufficient strength to prevent contamination between appointments; tooth-length determination should be done with precision--instrumentation beyond the apex should be avoided; caustic irrigating solutions such as sodium hypochlorite should be avoided--sterile water or sterile saline solution is preferable. For fabrication of prostheses, the general practitioner should be aware that: metallic-oxide impression materials such as zinc-oxide and eugenol should be avoided because of their irritating properties; trismus is common when the masticatory muscles are bilaterally in the field of radiotherapy-therefore, to prevent encroachment on the freeway space for these patients, the vertical dimension of occlusion should be decreased accordingly; monoplane teeth are preferable to cusped teeth for patients with trismus because their border movements are often irregular-monoplane teeth cause less interferences and are easier for the patient to manage; a remount of the overdentures to check the occlusion as well as a careful examination of flange extensions are necessary to prevent tissue ulcerations that could lead to tissue and bony necroses. Cast restorations should be avoided for patients with severe caries after radiation therapy (for example, a cast core and dowel). Prevention of postradiotherapy treatment complications is the primary goal in the management of the patient who has had head and neck cancer. If, however, the patient who has received radiation therapy and as a result has severe caries does come to the general practitioner, a logical and organized treatment plan can be followed that will result in control of the carious disease process and the functional rehabilitation of the patient.

Computed tomography of Sipple syndrome.

The computed tomographic (CT) findings of pheochromocytoma, adrenal medullary hyperplasia, and medullary thyroid carcinoma in a patient with Sipple syndrome are presented. The CT finding of diffuse enlargement of one or both adrenal glands in a patient with clinical and laboratory evidence of pheochromocytoma should raise the suspicion of adrenal medullary hyperplasia and Sipple syndrome.

Burkitt lymphoma in acquired immune deficiency syndrome.

An unusual case of Burkitt lymphoma presenting with an osteolytic pelvic lesion in a homosexual man with acquired immune deficiency syndrome (AIDS) is reported. Computed tomography (CT) demonstrated unsuspected renal involvement and was used for guided percutaneous biopsy. The CT appearance of renal Burkitt lymphoma was similar to that of other types of renal lymphoma.

[The composition of dietary lipids and the blood coagulation time in the rat]. / Rôle de la composition en lipides du régime sur le temps de coagulation du rat

The study of the coagulation in rats fed with a balanced diet, including 12% of different animal or vegetable fats, during 6 months, shows that the time of coagulation in rats receiving one of the following oils: palm, sunflower, Canbra, is significantly higher than the ones fed with butter. On the other hand, the coagulation time observed in the groups is correlated with the oleic acid level in the corresponding diet. The results obtained here may lead to important practical applications.