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Coronary artery aneurysms are often incidental findings during coronary angiography; they are mostly secondary to atherosclerosis or vasculitis, they are rarely congenital. Right coronary circumflex and anterior descending arteries are usually involved but only few cases of aneurysms of left main coronary artery are reported. A case of coronary artery aneurysms is described involving left main, right and anterior descending coronary arteries, probably secondary to atypical Kawasaki disease in a 33 years old man with acute myocardial infarction.

The treatment of NIDDM patients with secondary failure to sulfonylureas is still a debated problem. In this study we compared in NIDDM patients with secondary failure to glyburide, the effect of adding a single, low-dose bed time either NPH or ultralent insulin injection (0.15-0.2 U/kg) to the previously ineffective sulfonylurea treatment. Both NPH and ultralent insulin therapy have been demonstrated to be effective in ameliorating metabolic control in NIDDM patients with secondary failure to sulfonylureas. However, the addition of bed-time ultralent insulin caused a greater and significant decrease in post prandial plasma glucose. In contrast, the average fasting plasma glucose decrease was significantly greater after NPH insulin administration. These results indicate that in NIDDM patients with secondary failure to glyburide bed-time ultralent insulin administration is a better tool to improve the post prandial plasma glucose.

Popliteal cysts presenting as thrombophlebitis are unusual diseases of the popliteal fossa and are commonly associated with rheumatoid arthritis or meniscal tears. The authors report the case of a 38-year-old man with Reiter's syndrome in which a synovial cyst of the popliteal space, mimicking symptoms suggestive of deep venous thrombosis, complicated the course of the arthritis. Clinical and diagnostic features of this rare popliteal pathology are discussed and the usefulness of noninvasive diagnostic methods for detecting this disease, in particular that of echotomography, is emphasized. The authors stress the importance of a correct diagnosis in order to avoid the risks of an erroneous anticoagulant treatment.

In order to evaluate the effects of ipriflavone therapy, a clinical and metabolic study was carried out in a group of female patients with low bone mass. In particular, mineral density of the proximal femur was measured, this being a fundamental factor for the resistance of this district. At the end of the 12-months treatment cycle, reduced plasma concentration of Bone Gla Protein and urinary hydroxyproline/creatinine ratio (indicating reduced bone resorption), and a significant increase of bone density of the femoral neck and of the trabecular substructure of Ward's triangle were found. On the whole, treatment was well tolerated.

Endomyocardial biopsy was performed in three patients affected by systemic connectivitis (one case of systemic lupus erythematosus--SLE--, one of scleroderma and one of dermatomyositis). The analysis of the specimens revealed the presence of fibrosis and microvascular lesions (these latter only in SLE). Immunofluorescence showed in SLE and scleroderma perivascular IgG or perisarcolemmal IgM deposits respectively. Despite the scarcity of cardiac signs and symptoms, cardiac involvement can be early and frequent in connectivitis. The immune pathogenesis of the cardiac lesions seems to be possible because of the presence of immunocomplexes in the myocardium.