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Stenosis and occlusion of superior vena cava (SVC) is not a rare entity in oncology. By-pass surgery, radiation therapy, and chemotherapy—when effective—are common treatments. Interventionist radiology offers a new way to solve the venous obstruction. Between April 1993 and January 1995, fourteen pts (11 males), aged 48–72 (median 58 years), presenting with SVC syndrome due either to lung cancer and mesothelioma (11 pts), or to breast, gastric, and kidney carcinomas (3 pts), were treated with a metallic stent caval placement. SVC obstruction was confirmed by means ofcomputed tomography and cavography (this last procedure, including venous pressure measurements, was repeated both after stenting and later at 1,3, and 6 months). Stent placing (GianturcoRosch Z-stent) was carried out via percutaneous femoral vein approach, after a 12–72 hour infusion of Urokinase (only in 6 pts showing significant SVC thrombosis) and caval stenosis dilatation with suitable balloon catheters. Heparin and/or warfarin were given for at least 7 days after the procedure, followed by aspirin (0.3 g daily). hnmediately after the Z-stent implantation, all patients experienced a dramatic symptom resolution. Both caval pressure and lesion diameter improved significantly. No inunediate and late complications or stent misplacements were observed. Two patients had a late recurrence of their SVC syndrome. To date, 10 pts are still alive at 4 to 10 months after stent placement.

This work deals with Messinian deposits belonging to the Neogene infill of the Rossano and Belvedere Basins, respectively developed along the fore-arc and the back-arc areas of the north Calabria accretionary wedge. The main goal is to characterize the carbonate and evaporitic sedimentation during the Messinian Salinity Crisis, in the general framework of the basin architecture and the interplay between eustatic vs tectonic controlled sea-level variations. Fieldwork integrated with seismic lines and well logs interpretations led to the revision of the general stratigraphy of the basins and the proposal of a new sequential stratigraphic model driven by cyclic sea-level variations. Each cycle, repeated at least two times during the Messinian Salinity Crisis time frame, begins with a relative sea-level fall responsible for the emplacement of prograding wedges composed of terrigenous and evaporitic deposits that, subsequently, evolve in the deposition of primary basin-fill evaporites. This phase is followed by open marine transgression due to relative sea-level rise that terminates the evaporite formation and predates the development of microbial dominated carbonate platforms associated with shallow-water evaporites. Both basins experienced intense tectonic activity during the Messinian, which could be responsible for huge basinward sediments exportation and fast decreasing in the accommodation space. However, this did not substantially influence the development of the systems tracts that, considering the basinal architecture, have been mainly controlled by eustatic sea-level variations. In fact, two major sea-level drops associated with basin restriction and aridity (cold) conditions seem to have caused the origin of two main evaporitic units as basin-fill evaporites, while consequent sea-level rises and less stressed condition, account for two carbonate units with limited evaporites and terrigenous deposition.

Purpose To evaluate long-term keratoconus stability after corneal crosslinking (CXL) with riboflavin. Methods In this prospective study, 57 eyes of 55 patients with progressive keratoconus, consecutively treated with ultraviolet A (UVA) - riboflavin CXL, were examined with the corneal topographer Pentacam, the biometer IOLMaster and the analyzer of corneal biomechanics Ocular Response Analyzer before and during a 24 months follow-up after CXL. Results Twenty-four months after CXL, there was a significant improvement in best corrected visual acuity (BCVA) (P < 0.01), a significant decrease in corneal thinnest point (CTP), keratometry readings at the keratoconus apex (K max), and corneal volume (CV) (P < 0.01), and a significant increase in axial eye length (AL) (P = 0.01). No significant changes in anterior chamber volume (ACV) and depth (ACD), (P = 0.8), corneal hysteresis (CH) (P = 0.16) and corneal resistance factor (CRF) (P = 0.06) were found. However, in the subgroup of patients with decreased K max readings 24 months after treatment, both CH and CRF showed a significant reduction (P < 0.01). Conclusion In the first month after the procedure, CXL induces a reduction in corneal volume. During the 24 months follow-up the cornea tends to recover its original volume with a persistence of the CXL efficacy.

See editorial on page 284. BACKGROUND & AIMS: The presence of celiac diseaseassociated autoantibodies (antiendomysium and antitissue transglutaminase [anti-TG2]) with normal jejunal mucosa indicate potential celiac disease. We performed a prospective, 3-year cohort study to determine the natural history of potential celiac disease in children. METHODS: The study included 106 children with potential celiac disease, based on serology analysis and normal duodenal architecture. All but 2 carried the HLA-DQ2 and/or DQ8 haplotype. In all children, every 6 months, growth, nutritional parameters, celiac disease serology, and autoimmunity were investigated. In biopsies, intraepithelial-, CD3-, and lamina propria CD25-positive cells were counted; duodenal deposits of anti-TG2 immunoglobulin A were detected. Biopsy analysis was repeated after 2 years on patients with persistent positive serology and/or symptoms. RESULTS: Celiac disease was detected primarily in firstdegree relatives and patients with autoimmune disorders (40.6%). A gluten-free diet was prescribed to 20/106 patients because of symptoms, which were relieved in only 11. Eightynine of the 106 patients entered the follow-up study, with normal daily consumption of gluten. During the follow-up antibodies disappeared in 14.6% and fluctuated in 32.6%. Villous atrophy was observed in 12/39 patients (30.8%) who underwent a repeat biopsy. CONCLUSIONS: Most children with potential celiac disease remain healthy. After 3 years, approximately 33% of patients develop villous atrophy. Intestinal deposits of anti-TG2 IgA identify children at risk for villous atrophy.

PURPOSE: To compare intraocular pressure (IOP) between patients with myotonic dystrophy (DM1) and normal subjects, taking into account corneal characteristics. To determine whether lower IOP measurements in patients with DM1 are due to thinner corneas. DESIGN: Comparative case series. PARTICIPANTS: Fifty-three eyes of patients with DM1 and 53 eyes of normal age- and sex-matched subjects. METHODS: Corneal biomechanical properties and corneal compensated intraocular pressure (IOPcc) measured with the Ocular Response Analyzer (Reichert Inc., Depew, NY), central corneal thickness measured with the Oculus Pentacam (Oculus, Wetzlar, Germany), and IOP were evaluated in patients with DM1 and compared with age- and sex-matched healthy subjects. MAIN OUTCOME MEASUREMENTS: Goldmann applanation tonometry, central corneal thickness, corneal hysteresis (CH), corneal resistance factor (CRF), and IOPcc. RESULTS: Compared with the healthy subjects, patients with DM1 showed lower IOP (12.4+/-3.6 mm Hg vs. 14.9+/-3.4 mmHg) (P