Mechanical work during stress-field translation in the human TMJ.

The pathomechanics of degenerative joint disease of the temporomandibular joint (TMJ) may involve fatigue produced by mechanical work on the articulating tissues. This study tested the hypotheses that mechanical work in the TMJ (i) varies with the type of mandibular activity, and (ii) is evenly distributed over TMJ surfaces. Ten healthy human participants were recorded with Magnetic Resonance Imaging (MRI) and jaw tracking. The data were used to reconstruct and animate TMJ activity. Aspect ratios, instantaneous velocities, and distances of stress-fields translation were used to calculate work (mJ). The results were analyzed by least-squares polynomial regression and ANOVA. Work magnitudes were related to peak velocity (R(2) = 0.92) and distance of stress-field translation (R(2) = 0.83), and were distributed over the joint surfaces (p < 0.03). During mandibular laterotrusion, average mechanical work was 1.5 times greater in the contralateral joint. Peak magnitudes of work (> 3000 mJ) were 4 times that previously reported.

Platelet serotonin transporter in coeliac disease.

We investigated a peripheral serotonergic marker, i.e. platelet tritiated imipramine (3H-IMI) binding sites, which are part of the 5-HT transporter complex similar to that present in the brain, in 20 patients affected by coeliac disease (CD), as compared with 20 healthy controls. Platelet membranes and 3H-IMI binding were carried out according to a standardized protocol. The results showed that coeliac patients had significantly lower 3H-IMI binding sites than controls. This finding would suggest the presence of a dysfunction at the level of the 5-HT transporter that might underline the psychic disturbances frequently observed in coeliac patients.

[Atypical and incomplete Kawasaki disease]. / Le forme atipiche ed incomplete della malattia di Kawasaki.

Kawasaki Disease (KD) is an acute systemic vasculitic disorder of childhood of unknown etiology. Initially KD was thought to be a benign disease, but later on it became obvious that cardiac manifestations are present in about 25-30% of patients and lead to death in about 0.5-2% of them. An early diagnosis and treatment are important to avoid an unfavourable prognosis. In recent years, a number of publications described patients in which the diagnosis was delayed because they did not fulfil the required criteria of KD. These forms of KD are known as atypical or incomplete KD. The aim of this work is to describe two cases of atypical KD observed at the Department of Pediatrics, University of Pisa during the year 1992.

[Apparent life threatening events (ALTE): prelude to SIDS? Description of 14 cases]. / ALTE: preludio alla SIDS? Descrizione di 14 casi.

The peak incidence of the Sudden Infant Death Syndrome (SIDS) is between 2 and 4 months of age. Its pathology is extremely heterogenous, infection, hypoxia and many others factors are all implicated. We examine here the possible relation between SIDS and Apparent Life Threatening Event (ALTE). We describe 14 cases that we have observed to establish a primary connection between these two situations and to identify a risk-group for an accurate follow-up.

[Intestinal intussusception in children]. / Invaginazione intestinale nel bambino.

Enteric intussusception is one f the most frequent causes of acute abdomen in early childhood, with an incidence of 1.3-2/1000 children born and higher frequency from the third to the twelfth month. Primary intussusception is related to predisponsing factors such as peristalsis disorders or Peyer's patch hypertrophy induced by viral infection. Secondary intussusception is due to organic injury in the intestinal wall. The most involved sites are the terminal ileum and the ileocecum, the most frequent type is ileocolic intussusception. Many clinical forms exist, including acute enteric intussusception with its pathognomonic triad intermittent abdominal pain, emesis and rectal bleeding and the atypical form with a neurological presentation, where sopor, myosis and muscular atonicity are dominating, Intussusception can also present in a subacute or chronic form with a slow and apsecific onset. In a retrospective investigation we examined 30 cases of intussusception in children hospitalized at the Pediatric Clinic of Pisa from the 1960s up to today. Our patients (16 males and 14 females) were aged between one month and two years. Clinical presentations resulted in; typical forms (60%), atypical forms (16%), subacute forms 13%) and recurrent forms (10%). Clinical suspicion was confirmed either by the presence of blood observed during rectal exploration, which is a pathognomonic sign, or by the opaque enema which led to recovery by means of hydrostatic reduction in 40% of the cases. The remaining patients (60%) underwent surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

[Celiac disease and cystic fibrosis: casual association?]. / Malattia celiaca e fibrosi cistica: associazione casuale?

The authors describe a case of association cystic fibrosis coeliac disease, which they have observed. The frequency of this association in the general population is of 1:2,000,000. M.A. presents little growth in terms of height and weight and intestinal alterations (an abundance of fatty and mucous stool). The initial diagnosis was that of coeliac disease. After two months of diet without gluten one observed an increase in weight, but o result for the intestinal disturbances. The positive result revealed from the sweat-test and the study of genomic mutation (delta F508) showed the diagnosis of cystic fibrosis associated with coeliac disease. The specific treatment of both syndromes resolved intestinal alterations and caused the diminution of the acute bronchitis frequent during the first and the second infancy.

[Williams-Beuren syndrome and celiac disease]. / Sindrome di Williams-Beuren associata a malattia celiaca.

The authors describe a case of Williams syndrome-Coeliac Disease that they have observed at the age of three years and 10/12. There are few reports in the literature. We focus on the variability of clinical and biochemical aspects of Williams Disease and the necessity for an adequate gastroenterologic follow-up (anti-gliadine antibody and anti-endomisium antibody) in these patients with little growth in terms of weight and height and intestinal alterations present in superior measure in companion with the reported standards for the same syndrome.

[Diencephalic syndrome. Case report and review of literature]. / Sindrome diencefalica. Segnalazione di un caso e revisione della letteratura.

We report the case of a twenty-three month old, normally eating child, affected by organic macies and severe dystrophy. After the negative response of blood and laboratory examinations let us exclude a malabsorption syndrome, only the performance of neuro-radiologic exams showed evidence of a subthalamic tumor as the cause of a "Diencephalic syndrome". Diencephalic syndrome or Russel's syndrome is a diencephalic tumor induced disease, which sets in the first three years of life. The disease clinical markers are a severe emaciation with appetite preservation and absence or very scarce evidence of any telltale neurological sign. the tumoral histo-pathology most frequently shows a low grade of malignancy astrocytoma, whose eradication is very often difficult because of the particular anatomic site. Choice treatment includes an excisional biopsy associated to chemotherapy and to radiotherapy.

[Reiter's syndrome. Apropos a pediatric case]. / Sindrome di Reiter. A proposito di una osservazione in età pediatrica.

The authors report the case of a 13-year-old girl affected with urethritis, conjunctivitis, and oligoarticular arthritis. These symptoms represent the classical triad of Fiessinger-Leroy-Reiter's syndrome. The research for HIV was negative and the antigen HLA B27 was absent. The young patients has been treated by FANS and tetracycline. The authors reviewed the literature and analyses the epidemiology-cal, etiological and clinical problems of this disease.

[Hypertrophic pyloric stenosis in infants. A retrospective study of cases observed in the years 1970-1990]. / La stenosi pilorica ipertrofica del lattante. Studio retrospettivo dei casi osservati negli anni 1970-90.

Although the definitive cause of infantile hypertrophic pyloric stenosis is unknown, it's probable that several predisposing risk factors would be associated with the condition. We analysed some perinatal factors in relation to the incidence of infantile hypertrophic pyloric stenosis among children observed during the period 1970-90. We examined 61 infants with surgically confirmed hypertrophic pyloric stenosis and, as controls, 61 healty children comparable for age. In every child we studied: sex, birth rank, pregnancy and delivery, birthweight, parental age, type of feeding, familial history of hypertrophic pyloric stenosis and of atopy, seasonal variation in incidence, AB0 and Rh blood phenotypes. In the 61 infants with hypertrophic pyloric stenosis, the incidence of three factors (male sex, primogeniture and feeding with artificial milk) was significantly higher than that in the controls. We conclude that infantile hypertrophic pyloric stenosis probably has a particular genetic basis, but perinatal factors are responsible for the rising of the condition. However the true aetiology remains to be elucidated.

[Use of intravenous immunoglobulins in Guillain-Barré syndrome]. / L'impiego delle immunoglobuline per via endovenosa nella sindrome di Guillain-Barré.

The aim of the study was to assess the utility of intravenous integral molecule immunoglobulin treatment in Guillain-Barré syndrome. The etiopathogenesis of this syndrome is still unclear but it seems increasingly likely that immune phenomena are involved in the genesis of the neurological lesions. This would explain the efficacy of iv immunoglobulin treatment even if the effective mechanism of action can still only be hypothesised.