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Case Report: A 34-year-old man presented with anterior scleral thinning in the right eye (RE) and a painful nodular scleritis in the left eye (LE). Fundus examination showed a healed vasculitis and an inferior epiretinal neovascular membrane in the LE. Topical and systemic oral steroids and antiviral medication were prescribed. One year later, optic disc hyperaemia and swelling and macular oedema became apparent in the LE. Pulsed intravenous steroids were administered for 1 year, when a nasal septum perforation and vitreous haemorrhage in the LE were diagnosed. The eye was enucleated 3.5 years after the initial complaint. Necrotizing granulomatous tissue replacing the sclera and subconjunctival granulomatous tissue were observed. Six months later, oedema and neovascularization of the right optic disc were observed and cyclophosphamide was started, with regression of the clinical signs. No systemic abnormalities have so far become apparent., Discussion: Posterior scleritis is most often observed in patients with no signs of associated systemic autoimmune disease. The diagnosis in this case is most probably one of Wegener's granulomatosis (WG). In WG, the diagnosis is based on necrotizing granulomas of the respiratory tract, generalized focal necrotizing vasculitis and focal necrotizing glomerulonephritis. Eye involvement with WG has been reported in up to 58% of cases. Evaluation of the scleritis patient should include a detailed medical history, chest X-rays, blood tests, autoantibody serology and analysis of urinary sediment. Cyclophosphamide is the treatment of choice for patients with ocular manifestations of WG, polyarteritis nodosa or rheumatoid arthritis, either alone or in combination with systemic steroids. Visual loss is expected in 85% of individuals with severe necrotizing posterior scleritis.

Purpose: The purpose of our study was to compare the effects of systemically administered acetazolamide and topical apraclonidine 0.5% in the control of intraocular pressure (IOP) following phacoemulsification of senile cataracts., Setting: The study was conducted on patients affected by cataract and followed at the Department of Ophthalmology., Methods: Seventy-eight eyes in 78 patients were selected. Twenty-six eyes were randomly assigned to postoperative treatment with topical apraclonidine 0.5%, 26 received oral acetazolamide and the remaining 26 received no hypotensive treatment (control group). Statistical analyses were performed mainly by means of analyis of variance., Results: IOPs measured 24 h after surgery were significantly (p = 0.01) lower in the apraclonidine group compared to the control group., Conclusions: Our double-blind prospective study conducted on patients randomly assigned to treatment with apraclonidine or acetazolamide shows that the former drug is undoubtedly effective in the prevention of IOP increases following phacoemulsification. IOPs recorded in patients treated with this drug were lower than those observed in the acetazolamide and the control groups. Considering the lower risk of toxicity associated with topical administration, apraclonidine 0.5% seems to be preferable to oral acetazolamide in this postoperative setting., (Copyright 2006 S. Karger AG, Basel.)

In a system consisting of two different lattices, structural stability is ensured when an epitaxial relationship occurs between them and allows the system to retain the stress whilst avoiding the formation of a polycrystalline film. The phenomenon occurs if the film thickness does not exceed a critical value. Here we show that in spite of its orthorhombic structure, a 14 nm-thick NiSi layer can three-dimensionally adapt to the cubic Si lattice by forming transrotational domains. Each domain arises by the continuous bending of the NiSi lattice, maintaining a close relationship with the substrate structure. The presence of transrotational domains does not cause a roughening of the layer, but instead it improves the structural and electrical stability of the silicide in comparison with a 24 nm-thick layer formed using the same annealing process. These results have relevant implications for the thickness scaling of NiSi layers which are currently used as metallizations of electronic devices.

The best-known situation indissolubly linked to mosaicism is the uniparental disomy where a trisomic or monosomic zygote develops at least one cell line with 46 chromosomes. The mosaicism normal/abnormal cell lines may remain confined to placenta or persist in the embryo. Here, we describe a second situation that might also be indissolubly linked to a mosaic condition or at least to a confined placental mosaicism. We analysed the case of a mosaicism del(8p)/inv dup(8p) found in prenatal diagnosis. We had already demonstrated that the first product of the abnormal meiotic recombination at the basis of the inv dup rearrangements is a dicentric chromosome. Its breakage leads to the formation of a deleted and an inv dup chromosome. Although we had previously assumed that the dicentric underwent a breakage at meiosis II so that the zygote inherited the inv dup chromosome, our findings and those of others indeed indicate that the dicentric may be inherited in the zygote and that it might persist as such in early postzygotic stages, then undergoing different breakages in different cells leading to different abnormal chromosomes, either deleted or duplicated. Selection versus the most viable cell line(s) results either in a confined placental mosaicism with the inv dup cell line as the only one present in the embryo or in children with both the deleted and the inv dup cell lines. Phenotype/karyotype relationships in inv dup rearrangements must also take into account the influence of the other abnormal cell line during embryogenesis.

Posttraumatic dacryostenosis represent a troublesome sequela for patients who have sustained centrofacial trauma and can determine complexity in diagnosis and treatment. This article, based on a retrospective analysis of 58 patients with naso-orbitoethmoidal (NOE) trauma, reports the incidence of posttraumatic dacryostenosis and the evolution of such impairments in consideration of fracture type. Experience in diagnosis and treatment is illustrated, and surgical outcomes 6 months after external dacryocystorhinostomy (DCR) are reported. Posttraumatic epiphora was observed in 27 patients with NOE fractures (46.5%). In 10 cases, temporary epiphora was encountered and spontaneous recovery of lacrimal drainage within 5 months was observed. In the remaining 17 cases, permanent epiphora was registered and a frequent association with delayed treatment of facial fracture repair or bone loss in the lacrimal district was found. Surgical reconstruction of lacrimal pathways was performed 6 months after primary surgery, with external DCRs in all 17 patients with epiphora and the presence of nasolacrimal duct obstruction observed with dacryocystorhinography. External DCR with a large rhinostomy achieved a success rate of 94% in the reconstruction of lacrimal drainage. Such a technique proved to be effective in the treatment of posttraumatic dacryostenosis, although patients considered the temporary presence of external scars and stenting material to be a major problem.

Objective: In light of the research and the use of lasers in the therapy of xanthelasmas, the authors report their experience in the treatment of this pathology with Erbium:YAG laser., Materials and Methods: In 30 patients, all female, 70 xanthelasmas were treated with Erbium:YAG laser, 65 (93%) of which were on the upper eyelid and 5 (7%) on the lower eyelid, varying from 1 x 1.5 mm to 11 X 20 mm in size. Spots with a diameter of 1.6 mm, energy of 300 mJ, frequency of 1-5 Hz and in a number varying were used in relation to the extent of the pathology., Results: In all cases, the appearance and functional results were good, without leaving scars and/or dyschromia., Conclusions: Erbium:YAG laser, in the treatment of xanthelasmas, is a parasurgical method that is simple to perform and because of the successful aesthetic and functional results, is a valid alternative to the more traditional treatment methods.

High-frequency ultrasound biomicroscopy (UBM) has extensive powers of resolution. This makes it possible to explore and study some areas of the anterior segment with a clarity close to that of histologic preparations. High-frequency UBM was used in the clinical evaluation of 10 glaucomatous eyes subjected to ab externo holmium:yttrium-aluminum-garnet (Ho:YAG) laser sclerostomy. The anatomic characteristics of the fistular paths were viewed and compared with echographic images. The authors demonstrated that in the 5 cases where the filtering bleb, fistular path, and internal ostium were present, there was a reduction of intraocular pressure. UBM is a high-definition diagnostic instrument in the follow-up of fistular paths and filtering blebs after Ho:YAG laser sclerostomy, making it possible to reoperate at an early stage before the onset of clinical manifestations.

This study was carried out to determine the clinical efficacy and the clinical safety of azithromycin in a group of children with acute respiratory tract infections. The study involved 82 children treated with a single daily 10 mg/kg dose of azithromycin for three consecutive days. 7 days later, the overall clinical response was 100% (cure and improvement): bacteriological cure was achieved in 97.5% of the patients treated. Recurrences were never observed. Side effects not requiring interruption of therapy were observed in 3 patients (3.6%). The side effects were gastrointestinal disturbances. In conclusion azithromycin showed a remarkably clinical efficacy for treatment of acute respiratory infections in children. Tolerability and therapeutic compliance were excellent.

After describing the main clinical features of primary empty sella syndrome and the main hormonal alterations in chronic renal failure, the authors report the results obtained in a group of 33 patients undergoing dialysis three times a week. Each patient had a complete ophthalmologic examination, with electroretinography and visual-evoked potentials, a complete radiologic examination, including skull stratigraphy (particularly of the sellar and parasellar bony structures), and a computed tomographic scan. In the whole group, visual acuity, ocular and lid motility, and visual fields were normal. In two patients, a slight bilateral papilledema, associated with a P100 latency increase and normal morphology and visual-evoked potentials, was reported. Two patients had initial unilateral papillary pallor associated with P100 amplitude alterations. In all four of these patients, radiologic examination showed a markedly pathologic sellar widening with thickening and double contour image of the floor. The report of a primary empty sella was confirmed by computed tomography in all four cases. The authors discuss the possible etiopathogenic mechanisms of the neuroophthalmologic symptoms associated with this syndrome.

The Brisighella Study was performed in a little Emilia-Romagna town with agricultural background to observe coronary heart disease risk factors in this population. At entry, 1972, 1491 males and 1448 females were controlled from the residents of the inner part of the town. The participation response was very high (93%). In this study the hypertension evaluation as risk factor is reported. Measurement of blood pressure has been made in according to W.H.O. criteria. Blood pressure mean values, hypertension prevalence, borderline blood pressure prevalence and hypertension control level have been recorded. The male subjects with hypertension were 33.53%, while female subjects were 33.77%. Borderline blood pressure was higher in males than in females (32.0% vs. 25.7%). Hypertension control level in the examined sample was quite low, however, it appears higher than other reported in similar studies.

The comparative advantages and limitations of macrodacryocystography and echography for evaluating disorders of the lacrimal system are discussed and illustrated. In our opinion, macrodacryocystography is superior to ultrasonography in identifying the site and the nature of anatomical and functional abnormalities and in evaluating the effectiveness of treatment after surgery. Echography, however, is particularly useful in the study of the lacrimal sac, especially if an occlusion of the common canaliculus prevents filling of the lacrimal sac, thus ruling out macrodacryocystography.

In the course of studies evaluating diet as risk factor of atherosclerotic disease, an epidemiological study among 1491 males and 1448 females living in Brisighella, a small village in the Tuscan-Emilian Appenines, was carried out. The methods used in estimating alimentary habits have been described in detail. The weights of all foods eaten by each subject in a 7 day period were also recorded. We considered total intake of proteins, fats and carbohydrates in g/kg of ideal weight/day and total calories/kg of ideal weight/day and related such values to those given by FAO/WHO. It was observed that mean intake of proteins and fats in g/kg/day and cal/kg/day was always more elevated when compared with those given by FAO/WHO for males and females. Mean intake of carbohydrate, in both sexes, agreed with FAO/WHO values. Therefore, we can affirm that the people of Brisighella have faulty dietary habits, mainly concerning fats. In addition, their daily calorie-intake is too high.

The animal proteins in a low-lipid, low-cholesterol diet were substituted with a textured soybean preparation for 127 outpatients with stable type II hyperlipoproteinaemia selected from eight Italian and one Swiss lipid clinics. Eight weeks of the modified diet reduced plasma cholesterol by 23.1% in the 67 participating male patients and by 25.3% in the 60 females. No significant changes in plasma triglycerides, high-density lipoprotein cholesterol, and body weight were recorded. Better reductions in plasma cholesterol occurred in non-familial cases and in very young male patients. The acceptable taste of the soybean preparation used in this study, and its easy handling, indicate that this type of dietary treatment may be suitable for outpatients.

The Epidemiological Study of Brisighella, a rural little town of Emilia-Romagna, started in 1972. At entry 1448 females and 1491 males, aged 14-84 years, were examined. In this paper the mean values of Total Serum Cholesterol (TC), Triglycerides (TC), Serum Uric Acid (SUA) and Fasting Blood Sugar (FBS) for age classes and sex, were described. This values were for all males, of 222.6 mg/dl (TC), 153.0 mg/dl (TG), 53.5 mg/dl (SUA) and 85.0 mg/dl (FBS). In the females the mean TC values were higher than in the males (226.2 mg/dl); the mean values of other parameters were lower: 129.1 mg/dl (TG), 83.3 mg/dl (FBS) and 47.0 mg/l (SUA).

The Brisighella Study, an epidemiological observational investigation on coronary heart disease risk factors was performed in a little Emilia-Romagna town with agricultural background. At entry, in 1972, 1,491 males and 1,448 females were enrolled from the residents of the inner part of the town. The participation response was very high (93%). In this paper the smoking habits and physical activity are reported. The prevalence of smoking habits was 51.8% in males, quiet different from the female group (24.5%). Heavy smokers were more frequently observed in young people, than in the oldest female groups. The physical activity mean levels were very low both in males and in females and the prevalence of heavy physical activity during leisure time was very low, especially in the woman.