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   2012| October-December  | Volume 24 | Issue 4  
    Online since October 7, 2015

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Antioxidants: Are we abusing it?
TG Shrihari, Vijeev Vasudevan, S Kailasam, Devaraju Devaiah, V Manjunath, GR Jagadish
October-December 2012, 24(4):306-310
Oral cancer holds the eighth position in the cancer incidence ranking worldwide. with squamous cell carcinoma encompassing at least 90% of all oral malignancies. The World Health Organization expects that prognosis for many of these patients is grave and even in cases of successful treatment the degree of dysfunction and disfigurement postoperatively is well appreciated by all of us. Hence, understanding of the disease process is of paramount importance for early diagnosis and successful management. Dietary substitutes, such as betacarotene, provitamin A, vitamin A, C, and E, lipoic acid, zinc, selenium and Spirulina use in premalignant lesions, in premalignant conditions is still a debate. The antitumor activity of micronutrients is by their capability of destroying cancer cells through three major mechanisms: (i) Tumor inhibition by immune cytokines; (ii) stimulation of cancer suppressor genes, such as 'wild-type p54' and diminished expression or dysregulation of oncogenes, such as mutant p53 and H-ras; (iii) inhibition of angiogenesis-stimulating factors, such as transforming growth factor alpha (TGFa). Studies have shown that antioxidants are not the' magic bullet' for the treatment of premalignant oral mucosal lesions or the prevention of second primary malignancies. However, there is a role for antioxidants if used judiciously in selected cases that can be monitored carefully. An important principle is that the treatment should not be more harmful than the damage that the lesion can cause.
[ABSTRACT]   Full text not available  [PDF]
  1,011 152 -
Xeroderma pigmentosum: A rare case report with review of literature
B Anand, Subramanian Kailasam, P Mahesh Kumar, K Srividhya
October-December 2012, 24(4):334-337
Xeroderma pigmentosum, or XP, is an autosomal recessive genetic disorder in which the ability to repair DNA damage caused by ultraviolet (UV) light is deficient. In extreme cases, all exposure to sunlight must be forbidden, no matter how small. As such, individuals with the disease are often colloquially referred to as 'Children of the Night'. Mutations in XP genes that regulate nucleotide excision repair, not only predispose persons with xeroderma pigmentosum to multiple malignancies, but also promote premature cutaneous and ocular ageing, and in some cases promote progressive neurodegenerative changes. There is a great involvement of many parts of the body, especially head and neck. The oral manifestations are mainly related to the occurrence of malignant tumors in the lips, tongue and buccal mucosa. This paper reports a rare case of XP in a 40-year-old female presenting with dermatological, oral and ophthalmological involvement.
[ABSTRACT]   Full text not available  [PDF]
  923 193 -
Altered taste perception in oral submucous fibrosis: A research
R Deeplaxmi, Subhash B Sakarde, Jaideep Sur, Anand Pratap Singh, Supreet Jain, Sheetal Mujoo
October-December 2012, 24(4):288-291
The sense of taste is among the regulatory mechanism for acceptance or rejection of foods. In oral submucous fibrosis (OSMF) patients, impairment of taste sensation has not received much attention, owing to limited research work in the field. This study was conducted to analyze the taste impairment in OSMF patients by using four basic tastes: Sweet, sour, salty and bitter, among a group of 30 subjects by using physiological taste stimuli tastants. In OSMF, significant taste alteration was found with sweet followed by salt, bitter and sour.
[ABSTRACT]   Full text not available  [PDF]
  832 223 -
Identification of sex using lateral cephalogram: Role of cephalofacial parameters
Almas Binnal, BK Yashoda Devi
October-December 2012, 24(4):280-283
Introduction: Recognition of sex is an important aspect of identification of an individual. Apart from pelvis, skull exhibits highest sexual dimorphism in the human body- Lateral cephalograms are an invaluable tool in identification of sex as they reveal architectural and morphological details of the skull on a single radiograph- The equipment required for lateral cephalometry is readily available and the technique is cost-effective, easy to perform, offers quick results, reproducible and can be implemented in any special training for the forensic examiner. The present study was undertaken to evaluate the role of lateral cephalograms and the nine cephalometric variables in the identification of sex and also to derive a discriminant function equation for identification of sex. Materials and methods: A total of 100 lateral cephalograms were taken of 50 male and 50 female subjects aged between 25 and 54 years belonging to South Indian population. The nine derived cephabmetnc parameters were used to arrive at a discriminant function equation which was further assessed for its reliability among the study subjects. Results: Among nine cephalometric parameters used, seven were reliable in the identification of sex. The derived discriminant function equation accurately identified 88% of the male study subjects as males and 84% of the female subjects as females. Conclusion: The lateral cephalograms and the nine cephalometric variables employed in the study are simple and reliable tools of sexual discrimination. The derived discriminant functional equation can be used to accurately identify sex of an individual belonging to South Indian population
[ABSTRACT]   Full text not available  [PDF]
  859 168 -
CBCT in diagnosis of vertical root fracture
Mohan Thomas Nainan, Sunil Koshy, DN Naveen, Shiny Benjamin, R Murali, Rakshith Guru, KB Ashok
October-December 2012, 24(4):311-314
The clinical presentation and radiographic appearance of a vertical root fracture frequently pose a diagnostic dilemma to the clinician. Lack of definitive diagnosis often leads to unnecessary invasive surgery and/or extraction of the tooth. Often exploratory surgery is resorted in order to visualize the fracture. Conventional two-dimensional radiography, including periapical and bitewing radiograph and currently cone-beam computerized tomography (CBCT) are being used to detect vertical root fractures. This article reviews the role of CBCT in detecting vertical root fractures.
[ABSTRACT]   Full text not available  [PDF]
  744 94 -
Evaluation of efficacy of tacrolimus 0.1% in orabase and triamcinolone acetonide 0.1% in orabase in the management of symptomatic oral lichen planus randomized single blind control study
Manjunatha M Revanappa, Venkatesh G Naikmasur, Atul P Sattur
October-December 2012, 24(4):269-273
Objectives: Studies done on the management of oral lichen planus using tacrolimus are limited. The aim of the study is to compare the efficacy of tacrolimus with tramcinolone acetonide topically in the management of symptomatic oral lichen planus and also to evaluate adverse effects and opportunistic yeast infections. Materials and methods: A randomized controlled study was conducted on 60 patients with symptomatic lesions of oral lichen planus with biopsy proven who fulfilled the inclusion criteria. Study group comprised of 30 patients who received topical 0.1 tacrolimus in orabase therapy for 4 weeks. Control group comprised of 30 patients who received topical 0.1% triamcinolone acetonide in orabase for 4 weeks. Results: Significant improvement of symptoms (7.80 ΁ 1.90 to 1.2 ΁ 2.6) and clinical scores (3.1 ΁ 1.27 to 2.3 ΁ 1.1) in study group as compared to control group (7.60 ΁ 2.01 to 2.7 ΁ 2.5) and (2.73 ΁ 1.46 to 1.2 ΁ 1.4). No significant adverse effects were observed and no recurrence was noted during treatment and follow-up. Conclusion: Study group has shown significant clinical response (p = 0.002) when compared to control group. However, double-blind, controlled studies are needed to evaluate the efficacy of tacrolimus in the treatment of symptomatic oral lichen planus and to address the safety for long-term therapy.
[ABSTRACT]   Full text not available  [PDF]
  645 169 -
Optical coherence tomography in dentistry: An emerging perspective
MPV Prabhat, S Sudhakar, Karthikeya Patil, VG Mahima, K Srikrishna
October-December 2012, 24(4):324-329
Optical coherence tomography (OCT) is a non-invasive, real time diagnostic modality that enables detection of oral lesions at an early, relatively harmless stage with improved resolution. OCT gives quantitative and qualitative information of hard and soft tissue by providing a cross-sectional 'optical biopsy' of tissue up to 3 mm in depth from the surface. In the present scenario, OCT has emerged as one of the forefront imaging modality because of the wide variety of information and the three dimensional (3D) data it can provide. This article focuses on the basic sciences of OCT with its potential dental applications
[ABSTRACT]   Full text not available  [PDF]
  608 181 -
Research on orofacial pain in India: A bibliometric study
Mudit Gupta, K Srinivas, Satheesha B H Reddy, HJ Jai Krishna
October-December 2012, 24(4):292-295
Introduction: Orofacial pain is a common complaint affecting the lives of millions of people around the world. It is a public health problem and it is important to judge the extent of research undertaken in the diagnosis and management of orofacial pain and its underlying mechanisms. The aim of this study is to provide a quantitative overview of research on orofacial pain in Indian scenario by using bibliometric techniques on recent scientific publications on orofacial pain indexed in PubMed, IndMed and PakMediNet. Materials and methods: Data was collected from online databases viz- PubMed, IndMed and PakMediNet The data set included papers published during 2006 to 2010. Results: A total of 122 articles which were based on Indian scenario were published from 2006 to 2010 in PubMed, IndMed and PakMed Net. A total of 78.7% were published in Pubmed, out of which 54.2% were research based articles. Conclusion: Descriptive study of research done in India on orofacial pain from 2006 to 2010 based on PubMed, IndMed and PakMediNet database is presented. Taking into account the manpower available. research productivity in India in the field of orofacial pain is in its zygotic stages. The reason for this may be attributed due to the lack of standardization. The result of this study could be used by various professional societies, individual scientists, scholarly institutions and funding organizations to frame essential policies regarding the improvement of the research on orofacial pain in India and further studies could be done for assessment of quality of research.
[ABSTRACT]   Full text not available  [PDF]
  561 139 -
A study to analyze the different patterns of quid usage among subjects with chewer's mucosa
Saba Khan, Laxmikanth Chatra, K Prashanth Shensi, KM Veena, Prasanna Kumar Rao
October-December 2012, 24(4):284-287
Aim: Betel chewer's mucosa, although not considered as a potentially malignant lesion, has been suggested to be a precursor of oral submucous fibrosis (OSMF). Thus a study was undertaken to asses various quid chewing patterns in patients with chewer's mucosa and to evaluate possible association between chewer's mucosa and a particular quid usage patter. Materials and methods: The study was done on 150 subjects clinically diagnosed of having chewers mucosa lesion. After complete oral examination, a detailed habit history was taken through preformed questionnaire. The data obtained was analyzed using Chi-square test. Results: Among the 150 subjects males to female ratio was 8:2- Majority of the subjects were within the age group of 20 to 30 years and chewed a combination of betel leaf, arecanut, tobacco, lime- Majority of the subjects of chewer's mucosa used the quid for a duration of 1 to 5 years, a frequency of three to five quid per day. Conclusion: In the present study, chewers mucosa was seen in majority of the subjects who used the quid for a duration of 1 to 5 years, a frequency of three to five quid per day and chewed the quid containing betel leaf, arecanut, tobacco, lime as its constituents.
[ABSTRACT]   Full text not available  [PDF]
  576 122 -
Oral manifestations in diabetic and nondiabetic chronic renal failure patients on hemodialysis
V Asha, S Latha, Anuradha Pai, K Srinivas, KS Ganapathy
October-December 2012, 24(4):274-279
Introduction: Oral cavity reflects the general health status of an individual. Diagnosing and treating oral manifestations of systemic disease pose a greater challenge to oral physician. Chronic renal failure (CRF) is one such disease that demonstrates a complex set of oral findings due to disease itself and also due to treatment like hemodialysis- Diabetes, the most common cause of CRF also affects oral health. An attempt is made in this study to evaluate and compare oral health status of diabetic and nondiabetic CRF patients who were on maintenance hemodialysis Materials and methods: Study was done on 106 CRF patients who were on hemodialysis. Patients were divided into diabetic (55 patients) and nondiabetic (51 patients) group based on their blood sugar level Patients of both groups were examined for predialytic salivary pH, decayed, missing, filled teeth. periodontal condition and mucosal lesions. Results: Salivary pH in diabetic group was less when compared to nondiabetic group (p < 0.001). Diabetic group had higher caries prevalence (p < 0.001) and periodontal disease compared to nondiabetics. Conclusion: Study revealed decrease in salivary pH and increased prevalence of caries and periodontal disease in diabetic group. Differences in oral manifestations were also noticed between diabetic and nondiabetic uremic patients.
[ABSTRACT]   Full text not available  [PDF]
  566 113 -
Rhinomaxillary mucormycosis masquerading as chronic osteomyelitis: A series of four rare cases with review of literature
Neeta Mohanty, Satya Ranjan Misra, Sujit Ranjan Sahoo, Sobhan Mishra, Vijeev Vasudevan, S Kailasam
October-December 2012, 24(4):315-323
In a dental hospital, patients reporting with exposed bone in the palate/maxilla with or without pus discharging sinuses are generally clinically diagnosed as osteomyelitis which can occur as a complication of odontogenic bacterial infections, traumatic injuries, herpes zoster infection, aspergillosis, mucormycosis or iatrogenic infections. We present a series of four cases, all of which were initially clinically diagnosed as osteomyelitis and later confirmed to be mucormycosis following histopathological examination. Although rare, the common form of this opportunistic fungal infection is seen in the rhinomaxillary region and in people with an underlying systemic disease like diabetes mellitus (DM). This case series of rhinomaxillary mucormycosis is being reported to increase awareness among dental surgeons to regard the occurrence of osteomyelitis in the maxilla occurring in a immunocompromised patient especially with poorly controlled DM, with suspicion of an aggressive, fulminant, fatal fungal infection so as to ensure an early diagnosis and prompt treatment thereby reducing the morbidity and mortality associated with this disease.
[ABSTRACT]   Full text not available  [PDF]
  556 120 -
Compound composite odontoma
S Kailasam, S Manoj Kumar, B Anand, PE ChandraMouli, Vijeev Vasudevan, M Deivanayagi
October-December 2012, 24(4):350-353
Odontomas are the most common type of odontogenic tumors and generally they are asymptomatic. Frequently, it may interfere with the eruption of the teeth. This is a case report of a compound composite odontoma in a 10-year-old girl, which results in failure of eruption of the permanent upper right central incisor while the contralateral tooth had erupted. A calcified mass was seen in the radiograph and was provisionally diagnosed as odontoma following which the odontoma was enucleated. Routine follow-up was done for more than a year and no recurrence was seen. This case report indicates that early diagnosis and management ensures better prognosis.
[ABSTRACT]   Full text not available  [PDF]
  573 89 -
Prevalence of temporomandibular joint disorders in outpatients at Al-Badar Dental College and Hospital and its relationship to age, gender, occlusion and psychological factors
Raheel Ahmed Syed, Arshiya Ara Syeda, Girish Katt, Vini Arora
October-December 2012, 24(4):261-268
Background: Temporomandibular disorder (TMD) is a collective term that encompasses many clinical problems involving the masticatory muscles, temporomandibular joints (TMJ) and associated structures and it has high prevalence among populations. Aims and objectives: To determine the prevalence of TMD and its relationship to age, gender, occlusion and psychological factors and to evaluate which age group, gender, malocclusion parameters and psychological factors contribute to the prevalence of TMD. Materials and methods: The study includes a sample of 250 young adults (134 girls and 116 boys) with age ranging from 18 to 25 years, the presence and severity of TMD was determined using a self-administered anamnestic questionnaire composed of 10 questions regarding common TMD symptoms. Morphologic occlusion was evaluated according to Angle's classification (molar classes I, II, III) and to evaluate the psychological factors, The hospital anxiety and depression scale (HADS) developed by Zigmond and Snaith was used. Results: Data were computerized and the SPSS package (version 11.2) was used and nonparametric test of Chi-square for data analysis and unpaired t-test was also used for statistical data analysis. Anamnestic index (AI) showed that the percentage of women (5522%) had higher degree of TMD symptoms than compared with men (50.86%), comparing the age of men and women free TMD and with TMD, the statistical difference was not significant as (t = 1.35, p > 0.5), distribution of the cases among Angle's class I, II, III occlusion the difference was not statistically significant as (p > 0.5), the degree of anxiety and TMD degree among men and women patients, women had higher anxiety levels as compared to men and no statistical difference was found between the cases of men and women in the depression levels. Conclusion: Prevalence of TMD symptoms in our sample of 250 patients was high for women- Morphologic occlusion was not associated with the presence of TMD symptoms. By considering the psychological factors we found anxiety but not depression associated with TMD symptoms.
[ABSTRACT]   Full text not available  [PDF]
  515 130 -
Hypohidrotic ectodermal dysplasia with anodontia: A rare case-rehabilitation by prosthetic management
M Naveen Kumar, P Srinivas, S Ramadevi, S Raghavendra Prasad, P Ajayprakash, M Sudhakar
October-December 2012, 24(4):342-345
Ectodermal dysplasia is a hereditary disorder characterized by developmental dystrophies of ectodermal derivatives- It is characterized by triad of signs comprising sparse hair, abnormal or missing teeth and inability to sweat. This case of 12-year-old boy with hypohidrotic ectodermal dysplasia and complete anodontia of both primary and permanent dentition is presented. Owing to the need for treatment at an early age for anodontia and due to the ill-formed maxillary and mandibular residual ridges, the prosthetic management can be difficult. Complete dentures with soft liners and hollow maxillary denture were provided to encourage normal psychological development and to improve the function of the stomatognathic system.
[ABSTRACT]   Full text not available  [PDF]
  525 100 -
Expression of P53 protein in premalignancies and squamous cell carcinoma of the oral cavity
Poornima Chandra, PG Agnihotri, S Nagarathna
October-December 2012, 24(4):300-305
Introduction: Expression of p53 gene is one of the common findings in premalignancies and malignancies of the oral cavity. The aim of the study was to know whether P53 protein is overexpressed in histological sections of oral submucous fibrosis, oral leukoplakia and oral squamous cell carcinoma. The aim of the present study was to determine the overexpression of P53 protein in histological sections of oral submucous fibrosis, oral leukoplakia and oral squamous cell carcinoma. Materials and methods: Eighty-five histopathologically diagnosed. formalin-fixed, paraffin embedded tissue samples were divided into study group and control group. The study group was further subdivided into three groups: Group 1 consisted of 25 samples of oral submucous fibrosis: group 2 consisted of 25 samples of oral leukoplakia and group 3 consisted of 25 samples of oral squamous cell carcinoma. The control group consisted of 10 normal oral mucous membrane tissue samples. The samples were subjected to immunohistochemisty using indirect immunoenzyme Labelled StreptAvidin Biotin (LSAB) method. The results were analyzed statistically by Chi-square (X 2 ) test of significance Results: 8125 samples of group 1.5;25 samples of group 2. 8125 samples of group 3 and none of the samples of the control group were positive for P53 protein. P53 staining was seen mostly in the basal layer of the samples of group I while in the samples of groups 2 and 3 the staining was more diffuse. Conclusion: Among P53 may be considered a tumor marker as a definite number of samples were positive for P53
[ABSTRACT]   Full text not available  [PDF]
  508 113 -
Nonsyndromic multiple supernumerary teeth: A case report of 11 supernumerary teeth
Balaji Krishnan, Balaji Narasimhan, C Nirupama
October-December 2012, 24(4):296-299
Hyperdontia is an odontostomatologic anomaly characterized by an excess in both erupted and non-erupted teeth number. A23-year-old female patient reported to us with a chief complaint of malaligned teeth and inability to maintain oral hygiene. Extraoral examination did not reveal any abnormality. Intraoral examination revealed multiple supernumerary teeth in maxillary and mandibular premolar region. The teeth present were: 11, 12,13,14,16,17,18.21,22,23,24,25,26,27,28,31,32,33, 34, 35. 36, 37. 38, 41. 42, 43, 44, 45. 46, 47. 48. Apart from these teeth there were. One half erupted supernumerary tooth, distal to 14, one supernumerary tooth palatal to 14, one supernumerary tooth buccal to 15, one supernumerary tooth lingual to 34, one supernumerary tooth lingual to 36, one supernumerary tooth mesio lingual to 45,1 supernumerary tooth distolingual to 45. The panoramic radiograph was taken to study the presence of impacted teeth. It revealed- Two supernumerary teeth in 1st quadrant, three supernumerary teeth in 2nd quadrant, three supernumerary teeth in 3rd quadrant, one impacted mesial to 36, three supernumerary teeth in 4th quadrant, one impacted mesial to 46. Whenever, supernumerary teeth are diagnosed , a proper decision regarding the appropriate management should be made carefully_ In our opinion, the management of multiple supernumerary teeth poses a great challenge to clinicians. Therefore, it vital to for an interdisciplinary approach for the treatment.
[ABSTRACT]   Full text not available  [PDF]
  512 102 -
Bisphosphonates and osteonecrosis of jaws
Geetha Vijay, Vijay Raghavan
October-December 2012, 24(4):330-333
Bisphosphonates are used to treat osteoporosis. Paget disease of bone and other metabolic bone diseases, multiple myeloma, and skeletal events associated with metastatic neoplasms- In 2003, the first reports describing osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates were published. About 95% of these cases occurred among cancer patients receiving high-dose intravenous bisphosphonates. Approximately 5% of the reported cases have been in osteoporosis patients receiving low dose bisphosphonate therapy. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60% of cases are preceded by a dental surgical procedure. Oversuppression of bone turnover is probably the primary mechanism for the development of this condition, although there may be contributing comorbid factors. All sites of potential jaw infection should be eliminated before bisphosphonates therapy is initiated in these patients to reduce the necessity of subsequent dentoalveolar surgery. Conservative debridement of necrotic bone, pain control, infection management, use of antimicrobial oral rinses, and withdrawal of bisphosphonates are preferable to aggressive surgical measures for treating this condition. The purpose of the present article is to enlighten the dental fraternity about this frequently prescribed class of drugs with regard to its types and mode of action, and the implication of bisphosphonates-induced ONJ.
[ABSTRACT]   Full text not available  [PDF]
  490 108 -
In vivo Estimation of Redox States with Autofluorescence Spectroscopy in Oral Submucous Fibrosis Patients: A Pilot Study
V Jayanth Kumar, Koteeswaran Dornadula, Ganeson Singarovelu
October-December 2012, 24(4):257-260
Oral submucous fibrosis (OSMF) is a common premalignant condition occurring in Southeast Asia and Indian subcontinent. An early diagnosis and prompt treatment with patient counseling helps in the cure of the disease. Aim: The aim of this pilot study is to study and assess the redox ratio in patients with OSMF and normal patients. Materials and methods: This pilot study was carried out on in 10 patients visiting the Oral Medicine Department of our institution. After a thorough history, clinical examination and incisional biopsy the proven cases of OSMF were taken up for autofluorescence study. The representative site in the buccal mucosa was chosen based on clinical examination and the site was subjected to excitation with a light of wavelength 350 and 450 nm. This corresponds to the excitation wavelength of NADH and FAD respectively. The resulting emission intensities were obtained and the redox ratio was calculated. For control, about 10 cases of age-matched patients who had the habit of tobacco usage but without any lesions were chosen. Results: The redox ratio of patients with OSMF was 0.58 t 0.08 and in normal patients was 0.37 ± 0.04. Inference: The redox ratio is an indication of metabolic activity of the tissue being examined- From this study it could be concluded that an increase in redox ratio with a decreased cellular activity is seen in patients with OSMF.
[ABSTRACT]   Full text not available  [PDF]
  470 127 -
Management of perforating invasive cervical resorption: Two case reports
Sridhara Kenkre Subramanyappa, Bharath Parthasarathy, PG Manjegowda, S Rajeev
October-December 2012, 24(4):346-349
Invasive cervical resorption (ICR) is a type of external resorption that is not well understood or well known in the dental community. It is often misdiagnosed, leading to improper treatment or unnecessary loss of the tooth. Treatment may involve the periodontium as well as the tooth and pulp, and management can be complex. Early diagnosis and appropriate treatment are the keys to a successful outcome. This case reports elaborates the surgical management of the perforating ICR.
[ABSTRACT]   Full text not available  [PDF]
  454 87 -
Hemifacial hypertrophy: A rare case report
Pradhuman Verma, Kanika Gupta, Sudhir Rishi, Aishwarya Triwedi
October-December 2012, 24(4):338-341
Asymmetric variations of the contralateral structures of the head and face occur commonly in the general population and are an accepted feature of morphogenesis. A gross asymmetry characterized by marked unilateral overdevelopment of hard and soft tissues of head and face is a rare congenital malformation and has been termed as hemifacial hypertrophy (HFH). The etiology is unknown, but several theories have been proposed including hormonal imbalances, diseases involving the neural system, vascular conditions, lymphatic abnormalities, mechanical influences and congenital syphilis. Generally, treatment is not indicated for HFH unless cosmetic considerations are involved. An 8 years old boy reported to the Department of Oral Medicine and Radiology with the characteristic features of HFH. The case is presented to supplement existing clinical knowledge.
[ABSTRACT]   Full text not available  [PDF]
  403 71 -