Longitudinal study of human polyomaviruses viruria in kidney transplant recipients

INTRODUCTION

Immunosuppression after kidney transplantation (KTx) exposes recipients to Human Polyomaviruses (HPyVs) infections, whose natural history is still misunderstood.

METHODS

Allograft biopsies, and urine from 58 donor-recipient pairs were collected before KTx (T0) and 1 (T1), 15 (T2), 30 (T3), 60 (T4), 90 (T5), 180 (T6), 270 (T7), 360 (T8), and 540 (T9) days after transplant. Specimens were tested for JC (JCPyV) and BK (BKPyV), by quantitative Real-Time PCR. The course of post-KTx HPyVs viruria, and the association between JCPyV viruria in recipients and donors, were evaluated.

RESULTS

HPyVs were detected in 3/58 (5.2%) allograft biopsies. HPyVs viruria was present in 29/58 (50%) donors and 41/58 (70.7%) recipients. JCPyV DNA was detected in 26/58 (44.8%) donors and 25/58 recipients (43.1%), 19 of whom received kidney from JCPyV positive donor, whereas BKPyV genome was detected in 3 (5.2%) donors and 22 (37.9%) recipients. The median time of JCPyV, and BKPyV first episode of replication was 1, and 171 days post KTx, respectively. At T0, JCPyV viruria of donors was associated with increased risk of JCPyV replication post-KTx; recipients with JCPyV positive donors showed lower risk of BKPyV replication post-KTx.

CONCLUSIONS

The results suggested that JCPyV may be transmitted by allograft, and that its replication post KTx might prevent BKPyV reactivation. Future investigation regarding correlation between chronic exposure to immunosuppressive agents and HPyVs urinary replication are warranted.

Breastmilk from COVID-19 negative lactating mothers shows neutralizing activity against SARS-COV-2

Breastmilk protects newborns from infections through specific and nonspecific compounds. This study investigated the neutralizing activity against SARS-CoV-2 of breastmilk from SARS-CoV-2 negative, unvaccinated mothers, and compared it to that from infected nursing mothers. We enrolled women after COVID-19 swab testing results upon maternity admission, and divided them into two groups: group A, COVID-19-positive mothers, and group B, negative mothers. Breastmilk was randomly sampled at 2, 7, and 20 days postpartum. We collected 19 samples for Group A and 41 for Group B. A microneutralization assay was used to determine the 50% neutralization (NT50) titre. The presence of neutralizing antibodies was also determined. Group A had 100% neutralizing samples at 2 days postpartum (T0), declining 7 days postpartum (T1) and 20 days postpartum (T2). Group B samples exhibited neutralizing activity mostly at 7 days postpartum (T1) (90%). Negative mothers' samples showed no correlation between NT50 titres and antibodies' presence, suggesting that non-specific breastmilk components may exert antiviral action against SARS-CoV-2.

In-vitro antiviral activity and in-silico targeted study of quinoline-3-carboxylate derivatives against SARS-Cov-2 isolate

In recent years, the viral outbreak named COVID-19 showed that infectious diseases have a huge impact on both global health and the financial and economic sectors. The lack of efficacious antiviral drugs worsened the health problem. Based on our previous experience, we investigated in vitro and in silico a series of quinoline-3-carboxylate derivatives against a SARS-CoV-2 isolate. In the present study, the in-vitro antiviral activity of a series of quinoline-3-carboxylate compounds and the in silico target-based molecular dynamics (MD) and metabolic studies are reported. The compounds' activity against SARS-CoV-2 was evaluated using plaque assay and RT-qPCR. Moreover, from the docking scores, it appears that the most active compounds (1j and 1o) exhibit stronger binding affinity to the primary viral protease (NSP5) and the exoribonuclease domain of non structural protein 14 (NSP14). Additionally, the in-silico metabolic analysis of 1j and 1o defines CYP2C9 and CYP3A4 as the major P450 enzymes involved in their metabolism.

Broad Antiviral Effects of Echinacea purpurea against SARS-CoV-2 Variants of Concern and Potential Mechanism of Action

SARS-CoV-2 variants of concern (VOCs) represent an alarming threat as they show altered biological behavior and may escape vaccination effectiveness. Broad-spectrum antivirals could play an important role to control infections. The activity of Echinacea purpurea (Echinaforce® extract, EF) against (i) VOCs B1.1.7 (alpha), B.1.351.1 (beta), P.1 (gamma), B1.617.2 (delta), AV.1 (Scottish), B1.525 (eta), and B.1.1.529.BA1 (omicron); (ii) SARS-CoV-2 spike (S) protein-pseudotyped viral particles and reference strain OC43 as well as (iii) wild type SARS-CoV-2 (Hu-1) was analyzed. Molecular dynamics (MD) were applied to study the interaction of Echinacea's phytochemical markers with known pharmacological viral and host cell targets. EF extract broadly inhibited the propagation of all investigated SARS-CoV-2 VOCs as well as the entry of SARS-CoV-2 pseudoparticles at EC50's ranging from 3.62 to 12.03 µg/mL. The preventive addition of 25 µg/mL EF to epithelial cells significantly reduced sequential infection with SARS-CoV-2 (Hu-1) and OC43. MD analyses showed constant binding affinities to VOC-typical S protein variants for alkylamides, caftaric acid, and feruloyl-tartaric acid in EF extract and interactions with serine protease TMPRSS-2. EF extract demonstrated stable virucidal activity across seven tested VOCs, likely due to the constant affinity of the contained phytochemical substances to all spike variants. A possible interaction of EF with TMPRSS-2 partially would explain the cell protective benefits of the extract by the inhibition of membrane fusion and cell entry. EF may therefore offer a supportive addition to vaccination endeavors in the control of existing and future SARS-CoV-2 virus mutations.

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

More than two years have passed since the viral outbreak that led to the novel infectious respiratory disease COVID-19, caused by the SARS-CoV-2 coronavirus. Since then, the urgency for effective treatments resulted in unprecedented efforts to develop new vaccines and to accelerate the drug discovery pipeline, mainly through the repurposing of well-known compounds with broad antiviral effects. In particular, antiparasitic drugs historically used against human infections due to protozoa or helminth parasites have entered the main stage as a miracle cure in the fight against SARS-CoV-2. Despite having demonstrated promising anti-SARS-CoV-2 activities in vitro, conflicting results have made their translation into clinical practice more difficult than expected. Since many studies involving antiparasitic drugs are currently under investigation, the window of opportunity might be not closed yet. Here, we will review the (controversial) journey of these old antiparasitic drugs to combat the human infection caused by the novel coronavirus SARS-CoV-2.

Circulation of SARS-CoV-2 Variants among Children from November 2020 to January 2022 in Trieste (Italy)

Introduction: The ongoing coronavirus disease 19 (COVID-19) outbreak involves the pediatric population, but to date, few reports have investigated the circulation of variants among children. Material and Methods: In this retrospective study, non-hospitalized pediatric patients with SARS-CoV-2-positive nasopharyngeal swabs (NPS) were enrolled at the Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste (Italy), from November 2020 to January 2022. SARS-CoV-2 variants were identified by in vitro viral isolation, amplification, automatic sequencing of the receptor binding domain (RBD) of the SARS-CoV-2 spike coding gene, and subsequent next-generation sequencing. The growth curves of the isolated strains were defined in vitro by infecting Vero-E6 cells and quantifying the viral load in the supernatants up to 72 h post-infection by qRT–PCR. The neutralization activity of sera obtained from a COVID-19 vaccinated subject, recovered (2020) patient, vaccinated and recovered (2021) patient, and seronegative subject was assessed by microneutralization assay against the different variants. Results: In total, 32 SARS-CoV-2-positive children, 16 (50%) females, with a median age of 1.4 years (range: 1 day–13 years), were enrolled. The D614G amino acid substitution was detected in all isolated and amplified viral strains. Of the 32 isolates, 4 (12.5%) carried a nonsynonymous nucleotide mutation leading to the N439K (3/4), lineage B.1.258 (∆H69/∆V70), and S477N (1/4) substitution. In 7/32 (21.8%) isolates, amino acid substitutions allowed the identification of a delta variant, lineage B.1.617.2-AY.43, and in 1/32 (3.1%), the Omicron strain (B.1.1.529.BA1) was identified. The growth curves of the B.1, B.1.258 (∆H69/∆V70), B.1.617.2-AY.43, and B.1.1.529.BA1 variants did not show any significant differences. A reduction in the serum neutralizing activity against B.1.258 (∆H69/∆V70) only in a vaccinated subject (1.7-fold difference), against B.1.617.2-AY.43 in a vaccinated subject and in recovered patients (12.7 and ≥2.5-fold differences, respectively), and against B.1.1.529.BA1 variant (57.6- and 1.4-fold differences in vaccinated and in vaccinated and recovered patients) were observed compared to the B.1 variant. Conclusions: SARS-CoV-2 variants carrying the B.1.258 (∆H69/∆V70) and S477N substitutions were reported here in a pediatric population for the first time. Although the growth rates of the isolated strains (B.1.258, B.1.617.2-AY.43, B.1.1.529.BA1) did not differ from the B.1 variant, neutralizing activity of the sera from vaccinated subjects significantly decreased against these variants. Attention should be devoted to the pediatric population to prevent the spread of new SARS-CoV-2 variants in an unvaccinated and predominantly naive population.

Novel antiviral activity of PAD inhibitors against human beta-coronaviruses HCoV-OC43 and SARS-CoV-2

The current SARS-CoV-2 pandemic, along with the likelihood that new coronavirus strains will appear in the nearby future, highlights the urgent need to develop new effective antiviral agents. In this scenario, emerging host-targeting antivirals (HTAs), which act on host-cell factors essential for viral replication, are a promising class of antiviral compounds. Here we show that a new class of HTAs targeting peptidylarginine deiminases (PADs), a family of calcium-dependent enzymes catalyzing protein citrullination, is endowed with a potent inhibitory activity against human beta-coronaviruses (HCoVs). Specifically, we show that infection of human fetal lung fibroblasts with HCoV-OC43 leads to enhanced protein citrullination through transcriptional activation of PAD4, and that inhibition of PAD4-mediated citrullination with either of the two pan-PAD inhibitors Cl-A and BB-Cl or the PAD4-specific inhibitor GSK199 curbs HCoV-OC43 replication. Furthermore, we show that either Cl-A or BB-Cl treatment of African green monkey kidney Vero-E6 cells, a widely used cell system to study beta-CoV replication, potently suppresses HCoV-OC43 and SARS-CoV-2 replication. Overall, our results demonstrate the potential efficacy of PAD inhibitors, in suppressing HCoV infection, which may provide the rationale for the repurposing of this class of inhibitors for the treatment of COVID-19 patients.

Longitudinal, virological, and serological assessment of hospitalized COVID-19 patients

Here we described the virological and serological assessment of 23 COVID-19 patients hospitalized and followed up in Milan, Italy, during the first wave of COVID-19 pandemic. Nasopharyngeal (NPS), anal swabs, and blood samples were collected from 23 COVID-19 patients, at hospital admission, and periodically up to discharge, for a median time of 20 days (3-83 days). RNA was isolated and tested for SARS-CoV-2 by qRT-PCR; anti-SARS-CoV-2 IgM and IgG antibody titers were evaluated in serum samples by ELISA. SARS-CoV-2 genome was detected in the NPS swabs of the 23 patients, at the admission, and 8/19 (42.1%) were still positive at the discharge. Anal swabs were positive to SARS-CoV-2 RNA detection in 20/23 (86.9%) patients; 6/19 (31.6%) were still positive at discharge. The mean time of RNA negative conversion was 17 days (4-36 days) and 33 days (4-77 days), for NPS and anal swabs, respectively. SARS-CoV-2-RNA was detected in the blood of 6/23 (26.1%) patients. Thirteen/23 (56.5%) and 17/23 (73.9%) patients were seropositive for IgM and IgG, respectively, at the admission, and the median IgM and IgG levels significantly (p < 0.05) increased after 13 days. Although the limited cohort size, our report provides evidence that SARS-CoV-2 is shed through multiple routes, with important implications in healthcare settings.

VIRAL AGENTS AND SYSTEMIC LEVELS OF INFLAMMATORY CYTOKINES IN VULNERABLE AND STABLE ATHEROSCLEROTIC CAROTID PLAQUES

BACKGROUND

To investigate the presence of genetic material of viral agents and the serum level of inflammatory cytokines in patients submitted to carotid endarterectomy having vulnerable versus stable atherosclerotic plaques.

METHODS

Data of patients consecutively submitted to carotid endarterectomy for a significant stenosis from 07/2019 to 12/2019 were prospectively collected. The genetic material of Epstein-Barr (EBV), CitoMegalo (CMV), Herpes Simplex (HSV), Varicella-Zoster (VZV) and Influenza (IV) Viruses was searched in the patient's plaques, both in the "mid" of the plaque and in an adjacent lateral portion of no-plaque area. The serum levels of TNF-α, IL-1β, IL-6, IL10 and CCL5 were determined. The obtained results were then correlated to the histologic vulnerability of the removed carotid plaque. P values <0.05 were considered statistically significant.

RESULTS

Data of 50 patients were analyzed. A vulnerable plaque was found in 31 patients (62%). The genome of CMV, HSV, VZV and IV was not found in any of the vascular samples, while the EBV genome was found in the "mid" of two vulnerable plaques, but not in their respective control area. Eighty-two percent of patients who did not receive anti-IV vaccination (23/28) had vulnerable carotid plaque, compared with 36% of vaccinated patients (8/22, p=0.001). Serum levels of TNF-α and IL-6 were higher in patients with a vulnerable plaque compared to patients with a stable plaque (73.6±238.2 vs 3.9±13.1 pg/ml, p=0.01, and 45.9±103.6 vs 10.1±25.3 pg/ml, p=0.01, respectively), independent of comorbidities, viral exposure or flu vaccination.

CONCLUSION

The EBV genome was found in the "core" of two vulnerable carotid plaques, but not in their respective adjacent control. Influenza vaccination was associated with a lower incidence of carotid plaque vulnerability. Serum levels of TNF-α and IL-6 were higher in patients with a vulnerable plaque compared to patients with a stable plaque.

Isolation of SARS-CoV-2 strains carrying a nucleotide mutation, leading to a stop codon in the ORF 6 protein

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was isolated from the oro/pharyngeal swabs of two Italian COVID-19 patients, physicians in a COVID-19 division hospital, with different courses of the disease. The complete genome sequences show that the two isolates belong to the B1.1 lineage, but contain a nucleotide mutation in the ORF6, leading to a stop codon and to the deletion of 6 amino acids in the C terminus. This deletion was unique, compared to the currently available sequences deposited in the GISAID and GenBank database. It did not affect the in vitro viral replication, neither the neutralizing activities of the patients' antibodies. Based on homology analysis with other Coronaviruses, the two isolated lacked the ORF6 aminoacidic portion responsible for the inhibition of the antiviral Interferon (IFN)-based host response. IFN seems to have a dual role of in SARS-CoV-2 infected patients: not only antiviral activity, but also a detrimental role in case of excessive production. A deletion in the SARS-CoV-2 ORF6 protein might have a specific, still unknown role in the viral pathogenesis.

Human polyomaviruses genomes in clinical specimens of colon cancer patients

Colon cancer is the third cause of cancer death in the developed countries. Some environmental factors are involved in its pathogenesis, including viral infections. The possible involvement of human polyomaviruses (HPyVs) in colon cancer pathogenesis has been previously reported, leading to inconsistent conclusions. Clinical specimens were collected from 125 colon cancer patients. Specifically, 110 tumor tissues, 55 negative surgical margins, and 39 peripheral blood samples were analyzed for the presence of six HPyVs: JC polyomavirus (JCPyV), BK polyomavirus (BKPyV), Merkel cell PyV (MCPyV), HPyV -6, -7, and -9 by means of DNA isolation and subsequent duplex Real Time quantitative polymerase chain reaction. HPyVs genome was detected in 33/204 samples (16.2%): the significant higher positivity was found in tumor tissues (26/110, 23.6%), followed by negative surgical margins (3/55, 5.5%, p < .05), and peripheral blood mononuclear cells (PBMCs) (4/39; 10.3%). HPyVs load was statistically higher only in the tumor tissues compared to negative surgical margins (p < .05). Specifically, MCPyV was detected in 19.1% (21/110) of tumor tissues, 3.6% (2/55) of negative surgical margins (p < .05), and 7.7% (3/39) of PBMCs; HPyV-6 in 2.7% (3/110) of tumor tissues, and 1.8% (1/55) of negative surgical margins; one tumor tissue (1/110, 0.9%) and one PBMCs sample (1/39, 2.6%) were positive for BKPyV; JCPyV was present in 0.9% (1/110) of tumor tissues. HPyV-7 and 9 were not detected in any sample. High prevalence and load of MCPyV genome in the tumor tissues might be indicative of a relevant rather than bystander role of the virus in the colon tumorigenesis.

Human Endogenous Retroviruses Long Terminal Repeat Methylation, Transcription, and Protein Expression in Human Colon Cancer

Colon cancer is the fourth most common malignancy in both incidence and mortality in developed countries. Infectious agents are among the risk factors for colon cancer. Variations in human endogenous retrovirus (HERV) transcript and protein levels are associated with several types of cancers, but few studies address HERV expression in colon cancer. Fifty-eight patients with advanced-stage colon cancer were enrolled in this study. HERV-H, -K (HML-2), -P LTRs, Alu, and LINE-1 methylation levels and transcription of HERV-H, -K (HML-2), and -P env and HERV-K pol genes in normal adjacent and tumor tissues were investigated by pyrosequencing and RT-qPCR, respectively. Expression of the HERV-K (HML-2) Pol and Env proteins in selected tissues was examined by Western blotting. Associations between HERV transcript expression and methylation levels and between clinical characteristics and HERV expression were evaluated. Compared to adjacent normal tissues, LINE-1 was hypomethylated in tumor tissues (p < 0.05), whereas Alu, HERV-K (HML-2), and -H LTRs showed a decreasing trend in tumor tissue compared to normal tissue, though without a significant difference. The transcription levels of HERV env and pol genes were similar. However, the HERV-K (HML-2) Pol protein was more highly expressed (p < 0.01) in surrounding normal tissues, but the HERV-K (HML-2) Env protein was only expressed in tumor tissues. Although HERV LTR methylation and gene expression did not show significant differences between tumor and normal tissues, HERV protein expression differed greatly. Pol protein expression in normal cells may induce reverse transcription and subsequent integration into the host genome, likely favoring cell transformation; in contrast, the Env protein in tumor tissue may contribute to cancer progression through cell-to-cell fusion.

Human endogenous retroviruses env gene expression and long terminal repeat methylation in colorectal cancer patients

Human endogenous retroviruses (HERV) are remnants of exogenous retroviral infections, representing 8% of the human genome. Their regulation is based on the DNA methylation of promoters, the long terminal repeats (LTRs). Transcripts from HERV have been associated with cancers, but reports concerning HERV expression in colorectal cancer remain sporadic. Sixty-three patients with advanced stages of colorectal cancer were enrolled in this study. The expressions of HERV env gene, and HERV-H, -K, -R and -P LTRs and Alu, LINE-1 methylation levels, were investigated in the tumor, normal adjacent tissues, and, where possible, blood and plasmatic extracellular vesicles (EVs). Associations among HERV env expression, methylation status and clinical characteristics were evaluated. No differences were observed in HERV env gene expression levels among the clinical specimens, while Alu, LINE-1, HERV-H and -K LTRs were demethylated in the tumor compared to the normal adjacent tissues (p < 0.05).The HERV env gene was expressed in the EVs at of 54% (-H), 38% (-K), 31% (-R) patients. Association was not found between HERV env expression and LTR methylation, but significant higher expression of HERV-P and -R env was found in tumor tissues arising from the right colon. Our findings do not demonstrate significant overexpression of the studied HERV in colorectal cancer, but their association with tumor localization and specificity of the changes in DNA methylation of retroelements are shown. HERV sequences were packaged in the EVs and might be transferred from one cell to another.

Particulate matter exposure increases JC polyomavirus replication in the human host

BACKGROUND

Human polyomaviruses (HPyVs) asymptomatically infect the human population during childhood and establish latency in the host. Viral reactivation and urinary excretion can occur when the immune system is impaired. Exposure to particulate air pollution, including the PM₁₀/PM_2.5 components, is a public health problem and has been linked to several disorders. Studies assessing the relationship between PM₁₀/PM_2.5 exposure and viral replication are lacking.

OBJECTIVES

To investigate the relationship between HPyVs viruria and PM₁₀/PM_2.5 exposures.

METHODS

Individual environmental exposure was assessed in 50 healthy adult volunteers using a chemical transport model (CTM) with a municipality resolution for daily PM₁₀ and monitoring stations data for daily PM_2.5 exposures. For each subject, a urine sample was collected, and HPyVs (JCPyV, BKPyV, MCPyV, HPyV6, HPyV7 and HPyV9) loads were determined. Zero-inflated negative binomial (ZINB) regression was used to model the count data, as it contained excessive zeros. Covariates were chosen by stepwise selection.

RESULTS

HPyVs DNA was detected in 54% (median:87.6*10⁵ copies/ml) of the urine samples. JCPyV was the prevalent (48%, (median viral load:126*10⁵ copies/ml). Considering the load of the most frequently measured HPyVs, JCPyV, in the count-part of the ZINB model, every unitary in PM measured 2 days before urine collection (PM Day -2) was associated with an increase in JCPyV load (PM₁₀: +4.0%, p-value = 0.002; PM_2.5: +3.6%, p-value = 0.005). In the zero-part, the significant predictor was the PM₁₀ measured 5 days before urine collection (+3%, p-value = 0.03).

CONCLUSIONS

The environmental levels of PM₁₀/PM_2.5 increase the JCPyV viruria. Our findings emphasize the need for studies assessing the influence of air pollution exposure on the risk of viral reactivation.

Merkel cell polyomavirus DNA in the blood of patients with neurological diseases and healthy controls

Aim: Merkel cell polyomavirus (MCPyV) is the etiological agent of Merkel cell carcinoma. Its genome has been detected in anatomic districts from healthy and ill subjects. Data regarding the MCPyV DNAemia in neurological patients are lacking. Materials & methods: Blood was obtained from 129 neurological patients and 181 controls (HIV positive or negative). Real-time polymerase chain reaction (Q-PCR) was conducted to quantify MCPyV loads in blood specimens. Results: MCPyV DNA was detected in 17.1% of cases and 11.0% of controls in <1% of cells. No association between MCPyV DNA presence and HIV status was observed. Conclusion: Blood cells may be a reservoir for MCPyV. The presence of MCPyV genome in blood of healthy subjects might be relevant for transfusion medicine.

Enzymatic Analysis of the Gingival Crevicular Fluid in Hypoxia of High Altitude (Everest)

The aim of this study is to determine the qualitative and quantitative changes of alkaline phosphatase (ALP) that occur in the Gingival Crevicular Fluid (GCF) in hypobaric-hypoxic conditions (high altitude). Hypoxia affects systemic adaptation responses in different organs. We examined 17 Caucasians subjects, of whom 13 were mountain climbers (1 female and 12 males), and 4 Tibetans (2 females and 2 males) following exposure to the hypoxia environment of high altitude. The study was conducted at different altitudes (0 m control, 1000 m, 5200 m above sea level) on Mount Everest. The protocol consisted of withdrawing crevicular fluid through the use of cones made of endodontic paper size 30 sectioned to 15 mm from the apex, inserted for 30 seconds in the gingival sulcus (about 2 mm). The analyzed sites were the mesial and distal, buccal and palatal of tooth 1.1 and 2.1. Blood exams were performed on the subjects using I-Stat, furnishing analysis in real time (about 2 mins). In agreement with other results reported in literature, in all the subjects we found an increase in the hematocrit and hemoglobin with a large range of values between them, and with significant differences, as analysed with the Fisher, Scheffe and Bonferroni/Dunn statistical methods. The enzymatic analysis of the GFC showed an increase of the levels of ALP at each altitude studied. With this preliminary study we show that hypoxic environment determines not only the well known cardiovascular systemic responses, but also crevicular fluid adaptation.

Surgery on burns sequelae in developing countries

The purpose of this study is to analyze the effectiveness of surgery and follow-up of children operated on for burn sequelae. For many years, we have organized two missions per year to Benin and Togo, one for surgery and one for follow-up. We analyzed the files of children born in Africa and victims of burns from the years 2002 to 2011. Children were referred through a non-governmental organization (NGO) and assessed in Africa by local paediatricians before and after surgery. Treatment consisted in operating on burn sequelae such as contractures, hypertrophic scars and hard cords. Impaired mobility was our only indication for the operation. We kept a database on all patients. Sixty files were reviewed, of which fifty were deemed suitable for analysis. The most common methods of surgery were skin grafting and Z-plasty. There were no complications, such as infection or graft/flap necrosis after immediate surgery. Long-term follow-up revealed a recurrence of hypertrophic scarring (47%), retractions (24%) and hard cords (2%) due to a lack of occupational therapy and physiotherapy treatment. Partnership with an NGO and a local team allows us to treat children with burn injury sequelae in Western Africa. A continued and often long-lasting follow-up by occupational therapists and physiotherapists is highly mandatory in order to guarantee good long-term results. In 2010, we initiated local rehabilitation therapy.

Vascular Endothelial Growth Factor (VEGF) in Human Tooth Germ Center

Many oncogenis and tumour suppressor genes found inside normal and pathological cells are fundamental for the processes of development, proliferation and tissue differentiation. The purpose of our study is to show the presence and a possible relationship of the VEGF protein during different phases of the development of human dental germ centers. After cephalometric investigation in 8 orthodontic patients with a mean age of 13 years, (4 females and 4 males), hyperdivergence of the third molars were extracted. The 40 surgical samples were tested with monoclonal human anti-VEGFs antibodies carrying out a semi-quantitative analysis to look for a positive reaction. Reaction for anti-VEGF antibodies was detected in normal embryological tissues and in microvessels near odontogenic cells. During different phases of embryologic development of the dental bud our search showed intracytoplasmatic positive immunoreactions both in the ameloblastic and odontoblastic cells. Additionally, a positive reaction was observed for the VEGF protein in the cells of the stellate reticulum and in those endothelial tissue surrounding the microvessels in all the samples examined.

Potential Markers of Tongue Tumor Progression Selected by cDNA Micro Array

Squamous cell carcinoma (SCC), the most frequent malignant tumor of the oral cavity, generally exhibits a poor prognosis and metastases are the main cause of death. This tumor often arises from pre-malignant lesions. To date, it is difficult to predict if and which pre-malignant lesions may progress into oral SCC using traditional methods. For these reasons, several studies are trying to identify markers useful in the progression of pre-malignant lesions and tumors. To define the genetic expression profile of tongue tumor progression we compared 9 dysplasias (DS), 8 tumors without metastasis (TWM), 11 metastasizing SCCs (MT) of the tongue, and a baseline of 11 normal tissues by using cDNA microarray containing 19.2 K clones. We initially applied hierarchical agglomerative clustering based on information from all 6026 clones. Results were obtained by performing a two steps analysis: a Significance Analysis of Microarray (SAM) and a Gene Ontology search. One hundred and five clones have statistically significant different expression levels (FDR <0.01) between DS and TWM, whereas 570 genes have statistically significant difference expression levels between TWM and MT (FDR <0.01) as detected by SAM. By filtering with FatiGo only 33 genes were differentially expressed in TWN, respect to DS, whereas 155 genes were differentially expressed in MT respect to TWM. We detected some genes which encode for oncogenes, transcription factors and cell cycle regulators as potential markers of DS progression. Examples are BAG4, PAX3 and CCNI, respectively. Among potential markers of metastases are some genes related to cell mobility (TSPAN-2 and SNTA1), intercellular adhesion (integrin alpha 7) or extracellular matrix components (ADAMTS2 and cathepsin O). Additionally, under-expressed genes encoded apoptosis-related proteins (PDCD4 and CASP4). In conclusion, we identified several genes differentially expressed in tumor progression which can potentially help in better classifying premalignant lesions and tongue SCCs.

Prevalence and distribution of endodontic treatments and apical periodontitis in an Italian population sample

This study was undertaken to investigate for the first time the distribution and prevalence of apical periodontitis and its determinants in an Italian population. A total of 312 participants (191 women, 121 men) received free clinical examination and full-mouth digital X-ray. Data regarding the oral health status of the patients were collected such as the reason for the visit and the incidence of lesions. We examined 8101 teeth, 6.59% of which had been submitted to endodontic treatment and 15.02% of which were lower molars. Lower molars were reported missing more frequently, in detail 16.24%. Moreover 3.89% of the lower molars had developed an apical lesion, whereas only 0.08% of the lower incisors. Periapical lesions were present in 0.29% of not endodontically treated teeth, while in endodontically treated teeth lesions were present in 17.04%. Additionally, 15.65% of the endodontically treated teeth showed incongruous (long or short) seals. A prevalence of women (61.21%) over men (38.78%) was reported indicating that women attend to their oral health more. Endodontic treatment success and failure in over- or under-filled teeth was evaluated with success being verified in 97% of appropriately treated teeth; the success rate decreases in inappropriately treated teeth (by 72.73% in over-filled and 77.71% under-filled teeth). The prevalence of teeth with periapical lesions amounted to 1.35%. Finally, endodontically treated teeth with periapical lesions amounted to 17.04%. Successful treatment can be achieved when disease is intercepted at an early stage while prevention still remains better than cure.

Human herpesvirus-6 and polyomaviruses DNAemia in children and young adult patients after kidney transplantation

Aims: Human herpesvirus-6 (HHV-6) and polyomaviruses (HPyV) establish latency and reactivate in immunocompromised hosts. The prevalence of their infections was investigated in pediatric and young adult kidney transplant recipients. Materials & methods: Blood was obtained from 83 patients. Quantitative real-time polymerase chain reactions were conducted to quantify HHV-6 and HPyV loads; nested PCR and reverse transcriptase-PCR assays were conducted to differentiate HHV-6A from 6B and to evaluate the presence of transcripts. Results: HHV-6 and HPyV DNAemia were detected in 19.3 and 18.1% patients, respectively. No association between HHV-6 and HPyV DNA presence, age of patients and time from transplant was observed. Conclusion: HHV-6 infection in immunosuppression setting was as common as those of HPyVs that are commonly recognized as opportunistic agents.

The Role of Positron Emission Tomography in Inflammatory Bowel Disease

Inflammatory bowel diseases (IBD) are a group of pathological conditions characterized by chronic inflammation of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. To date, imaging of IBD is based on several radiological techniques such as barium studies, magnetic resonance imaging, and computed tomography (CT). Endoscopy is the gold standard for the assessment of the large bowel and proximal small intestine in patients with IBD allowing the biopsy of the visualized bowel. Positron emission tomography (PET) and PET/CT with Fluorine-18-fluoro-2-deoxy-D-glucose (FDG) is a functional imaging method used to detect abnormalities in glucose metabolism in a variety of disorders. FDG accumulates mainly in tumours, but increased uptake and retention has been shown also in lesions with a high concentration of inflammatory cells, such as granulocytes and activated macrophages. Recent literature data demonstrate that FDG-PET and PET/CT may be useful noninvasive tools for identifying and localizing active IBD. In patients with an established diagnosis of IBD, FDG-PET and PET/CT may provide information about disease activity, location and extent of the disease within the intestinal tract, allowing early recognition of disease relapse and possible complications. Furthermore, these techniques may play a role in assessing the treatment response to medical therapy in patients with IBD.

Aesthetic restoration of upper lip after removal of post-trauma foreign body (orthodontic bracket)

AIM

Approach to dental trauma should always be based on a careful examination of the traumatised area, including both hard and soft tissues, to ascertain the presence of a foreign body and to assess the best treatment and follow-up. In this work a case of an orthodontic bracket migrated to the upper lip and retained there for 10 years, following a trauma is discussed.

CASE REPORT

The patient complained symptomatic swelling of the upper lip; palpation and x-rays showed the presence of a foreign body, identified as an orthodontic bracket. Medical history revealed that patient had a dental trauma 10 years prior. The foreign body was localised and removed. At the two week follow-up visit after surgical incision of the lip, signs and symptoms (i.e. the swollen lip) were resolved. This case emphasises the importance of accurate management of the traumatic event, through proper diagnosis and therapy of both hard and soft tissues, even if the examination if the patient is performed years after the dental trauma.

Use of endosseous one-piece yttrium-stabilized zirconia dental implants in premolar region: a two-year clinical preliminary report

AIM

The aim of this work was to clinically and radiographically evaluate survival and success rate of zirconia dental implants positioned in premolar area during a follow-up period of at least 12 months up to 24 months.

METHODS

Sixteen patients were treated with 26 zirconia implants. All implants received immediate temporary restorations and 6 months after surgery were definitively restored. Twelve to 14 months after implant insertion, a clinical-radiographical evaluation was performed in order to estimate peri-implant tissues health and peri-implant marginal bone loss.

RESULTS

The survival rate was 96.16%. The success rate was 91.6%.

CONCLUSION

Because of the limited number of implants, conclusions may not be considered significant even if results are encouraging. Further scientific information regarding clinical use of zirconia dental implants are needed, as well as prospective long-term clinical studies in order to understand if zirconia implants may represent a valid alternative to titanium implants.

Edentulous jaws rehabilitation with yttrium-stabilized zirconium dioxide implants: two years follow-up experience

AIM

The aim of this study was to present authors' two-year clinical experience with Yttrium-stabilized zirconium dioxide implants placed in native bone or regenerated bone.

METHODS

Yttrium-stabilized zirconium dioxide implants made of brezirkon (whiteSKY, Bredent medical, Senden, Germany) were used for the treatment of edentulous ridge rehabilitation in the Dental Clinic of the University of Milan (Head of the Department, Prof. F. Santoro). Zirconium dioxide is a highly resistant ceramic material obtained by cleaning zirconium dioxide and zirconium silicate. The implant used in the clinical study featured a conical one piece implant with double cylindrical thread with a sandblasted rough surface. The prosthetic section was smooth.

RESULTS

Forty-six implants have been inserted in 18 patients from January 2007 to January 2009, the follow-up period was comprised between 6 and 24 months. The overall success rate was 89%; the success rate in native bone was 97% and 74% in augmented bone. It can be stated that the success rate is comparable to titanium fixtures.

CONCLUSION

It would be logical to use a ceramic material for the esthetic regions; zirconium dioxide is particularly suitable since it features tissue friendliness and resistance comparable to titanium. The good mechanical properties, possibility of easy fabrication of the prosthetic restoration and the good integration into the tissue and the esthetics provide perfect preconditions for yttrium-stabilized zirconium dioxide to become the most commonly used material in implant dentistry.

Displacement of a dental implant into the maxillary sinus: case series

Dental implants placed in the maxilla risk failure because of the low density of the maxillary bone and the shortness of the maxillary ridge. Moreover, inadequate implant preparation, drilling or installation can easily lead to complications related to the maxillary sinuses. Displacement of dental implants into the maxillary sinus can cause serious complications, but there are few reports of such cases. The aim of this paper is to present three cases of a migrated dental implants into the maxillary sinus: in the first two cases the dental implant was found close to the medial wall of the maxillary sinus and was removed through a surgical approach, whereas in the third case the dental implant was spontaneously expelled from the nasal cavities through the mucociliary clearance. The most frequent adverse effect is the local infection of tissue around the implant. For this reason, implants placed close to the maxillary sinus offer a route for infection from the oral cavity to the sinus. While in some cases implant migration causes sinusitis in other, the patients remain asymptomatic; anyway, the treatment depends on the symptoms of maxillary sinusitis. In the third case the dental implant was spontaneously expelled from the nasal graves. Our report illustrates that a powerful mechanism of mucociliary action can cause relatively heavy objects within the maxillary sinus to migrate naturally to the sinus ostia against gravitational force and then to be expelled from the nasal cavities.

Bevacizumab-Related Osteneocrosis of the Jaw

We describe a case of jaw bone necrosis after a lung adenocarcinoma bone metastasis, treated the first time in 2004 by means of pneumonectomy and lymph node ablation. One week after a dental extraction, the patient experienced pain in the mandibular region, in conjunction with alveolar bone exposure. Treatment with amoxicillin and clavulanate every 12 hours for 15 days and 0.2% chlorhexidine rinses was administered and there was a remission of infective complications, but not the closure of the exposed alveolar bone. Only at this time did the patient refer that he was treated with bevacizumab therapy immediately after the extraction. A preventive dental assessment of patients scheduled for bevacizumab therapy should be useful as for the zoledronic acid therapy. Dental surgery procedures for patients during bevacizumab therapy should be carefully evaluated and considered as the last choice, to reduce all possible risks and prevent complications.

Effect of a subgingival chlorhexidine chip on the clinical parameters and the levels of alkaline phosphatase activity in gingival crevicular fluid during the non-surgical treatment of periodontitis

The main therapeutic approaches for inflammatory periodontal diseases include the mechanical treatment of root surfaces. Multi-center clinical trials have demonstrated that the adjunctive use of a chlorhexidine (CHX) chip is effective in improving clinical results compared to scaling and root planing (SRP) alone. However, some recent studies failed to confirm these clinical results, nor have any data been reported regarding the capability of the CHX chip in affecting the activity of alkaline phosphatase (ALP) in the gingival crevicular fluid (GCF). This enzyme has been related to a condition of destructive activity of periodontitis. The aim of this study is to provide further data on the clinical and biochemical effects of CHX chips when used as an adjunct to SRP. Eighty-two systemically healthy patients, aged 31-63, with moderate and advanced periodontitis were recruited from the departments of Periodontology of the University of Chieti. In each patient 2 experimental sites, located in two symmetric quadrants, were chosen with a probing depth of > or = 5 mm and bleeding on probing. The 2 sites were selected randomly at the split-mouth level; control sites received SRP alone, and test sites SRP plus 1 CHX chip. Clinical indices, including probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and the ALP activity in GCF were evaluated at baseline and after 6 months. Alkaline phosphatase activity was assayed spectrophotometrically. The PPD and CAL were significantly lower at 6 months as compared to the baseline scores in both treatments (p less than 0.01). The PPD reduction was 2.7 mm in the CHX+SRP group and 1.9 mm in the SRP alone group. The CHX+SRP group showed a significantly greater gain of clinical attachment (mean: 1.4 mm) in comparison with the SRP group (mean: 0.9; p less than 0.05). No differences were observed in the decrease of the percent of BOP-positive sites between the experimental groups. Conversely, the CHX+SRP group underwent a significantly greater decrease (p less than 0.01) of the GCF-ALP activity 6 months after treatment in comparison with the SRP alone group. The adjunctive use of the CHX chip resulted in a significant improvement of pocket reduction and clinical attachment gain as compared with SRP alone. These results were concomitant with a significantly greater reduction of the GCF-ALP activity levels.

SEM analysis of oral lichen planus before and after treatment with 13 cis-retinoic acid

Cancer of the oral cavity is a frequent worldwide neoplasia, averaging 4% in men and 2% in women. Cancer of the oral cavity is often preceded by particular epithelial lesions, called precancerous lesions. The aim of this study is to evaluate, by SEM microscope analysis, before and after treatment with 0.1% 13-cis-retinoic, the morphostructural variation of the surface of the oral mucous affected by lichen planus in respect to healthy oral mucous. Following topical therapy with 0.1% 13-cis-retinoic acid for 8 weeks, a restoration of the physiological morphostructure was observed by SEM, demonstrating the efficaciousness of the treatment and the SEM analysis for identifying the lesions of oral epithelium.

Immunohistochemical Evaluation of VEGF Inflamed Cystic Radicular Lesions and in Keratocysts

Vascular Endothelial Growth Factor, also known as Vascular Permeability Factor, is a multifunctional cytokine hyperexpressed during angiogenesis and in numerous physiological and pathological processes characterised by an increase of vascular permeability. The aim of this study was to evaluate the angiogenetic processes which are accompanied by an expansion of cystic radicular lesions and of keratocysts of the jaw bone. 12 subjects were chosen with an average age of 43 years, of whom 8 were males and 4 females. After an accurate history and physical examination, the patients underwent surgery for removal of the cysts. The samples taken were histologically and immunohistochemical examined. The histological exam confirmed the diagnosis of radicular cysts and keratocysts. The immunohistochemical examinations were positive for VEGF in all the lesions analysed, even though they had different immunostaining. Using a semi-quantitative method, in the radicular cyst samples it was possible to highlight a wider expression of the vascular component, both in the inflamed area and the adjacent stroma. The lesions with keratin content showed newly formed and modest vascularisation both in the area showing slight inflammation, where the cellular component was prevalent, and in the adjacent areas showing no inflammation. Therefore, angiogenesis could take on a primary role in the development of cystic lesions of the jaw. However, the differences of expression of the VEGF protein suggest the need for wider monitoring to better evaluate a possible use of such a protein as a diagnostic marker.

Immunohistochemical evaluation of CD31 in human cystic radicular lesions and in keratocysts

Platelet-endothelial cell adhesion molecule-1 protein (PECAM-1/CD31) is expressed in numerous physiological and pathological processes characterized by an increase of vascular permeability, and in normal and tumour tissues. CD31, member of the immunoglobulin super-family that mediates cell-to-cell adhesion, is a transmembrane glycoprotein, 130-140 kDa, also know as platelet-endothelium cell adhesion molecule (PECAM-1). CD31 is a ligand for CD38 and plays a role in thrombosis and angiogenesis. CD31 is strongly expressed in endothelial cells and weakly expressed in megakaryocytes, platelets, occasional plasma cells, lymphocytes (marginal zone B-cells, peripheral T-cells) and neutrophils. The present study evaluates the angiogenetic processes which are accompanied by an expansion of cystic radicular and keratocystic lesions of the jaw bone. Twelve subjects with maxillary cysts (8 males and 4 females) with an average age of 43 years were selected by the Chieti University Oral Surgery Department. The surgical samples taken were subjected to histological and immunohistochemical analysis. The histological evaluation confirmed the diagnosis of radicular cystisis and keratocystisis. The immunohistochemical analyses were positive for CD31 protein in all the lesions analysed, even though they had different intensities. Using a semiquantive analysis it was possible to highlight, in the radicular cyst samples, an intense expression of the vascular component both in the inflamed area and the adjacent stroma. The lesions with cheratin content showed newly-formed, rather modest, vascularity both in the area showing slight inflammation, where the cellular component is prevalent, and in the adjacent areas showing no sign of inflammation. Therefore, in our observations, angiogenesis could take on a primary role in the development of cystic lesions of the jaw bones. The differences of CD31 expression, in all samples, would advise for a wider monitoring able to evaluate the possible use of such a protein as a diagnostic marker.

P-cadherin expression predicts clinical outcome in oral squamous cell carcinomas

P-cadherin, a transmembrane molecule similar to E-cadherin involved in the cell-cell adhesion, and catenins form complexes between its cytoplasmic domain and the cytoskeleton. Five cell lines, 108 specimens of oral squamous cell carcinomas (OSCC), 9 metastasis and 10 of normal oral mucosa were examined to evaluate P-cadherin expression and cellular localization by immunohistochemistry and western-blotting. In normal oral mucosa there was a membranous expression only in basal and parabasal layers. 91 cases (84%) showed membranous/cytoplasmic positivity, whereas 17 cases (16%) were negative. In particular, while well-differentiated carcinomas showed P-cadherin upregulation, the protein was homogeneously hypo- or unexpressed in low-differentiated carcinomas. There was a statistically significant correlation between P-cadherin expression and tumour grading: G3 tumours had a lower score than G1-G2 tumours (P<0.05). When analysed for prognostic significance, patients with no P-cadherin expression (score 0) had poorer overall and diseases-free survival rates than the P-cadherin-expressing group (score 1) (P=0.0463 and P=0.0471, respectively). Western blotting analysis of cell lines and tissue samples confirmed immunohistochemical findings. When cell staining pattern of positive cases was examined, 52 cases showed a prevalent membranous pattern, while 39 had a prevalent cytoplasmic pattern. Cases with prevalent cytoplasmic staining showed high rates of lymph node metastases (P>0.05), and regional relapse (P <0.05) and poorer survival rates than the group with prevalent membranous expression (P<0.0001). An absent P-cadherin expression could constitute a hallmark of aggressive biological behaviour in oral squamous cell carcinoma.

Cyclic GMP phosphodiesterase activity role in normal and inflamed human dental pulp

Cyclic GMP phosphodiesterase (cGMP PDE) plays an important role in pulp tissues. High levels of cGMP PDE are found in dental pulp cells. In the present study cGMP PDE activity was analyzed in normal healthy human dental pulps, in reversible pulpitis and in irreversible pulpitis. Enzymatic cGMP PDE control values for normal healthy pulps were 4.74+/-0.32 nmol/mg of proteins. In reversible pulpitis the cGMP PDE activity increased almost 3 times. In irreversible pulpitis specimens the values increased 4.5 times compared with the normal healthy pulps activity. The differences between the groups (control vs. reversible pulpitis and vs. irreversible pulpitis) were statistically significant. These results point to a role of cGMP PDE in the initial pulp response after injury.

[Parotid tumors: a diagnostic and therapeutic protocol in 81 surgical cases]

AIM

In the last five years we cured 81 patients divided in two groups: the first was managed inordinately, the second according to a diagnostic and therapeutic protocol.

METHODS

The first 23 patients were differently evaluated, before surgery, by means of traditional sialography, US, CT, CT sialography, MR, larger bore needles and FNAB. Neoplasm enucleations, atipic resections, superficial and total conservative parotidectomies were performed. The following 58 patients were evaluated and cured according to a diagnostic and therapeutic protocol.

RESULTS

Diagnostic and therapeutic time were shortened, patients endurance improved and cost lowered.

DISCUSSION

We think that many diagnostic procedures are useless and delay operation that, if possible, must be performed according to principles of radical extirpation.

Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man

BACKGROUND

Early implantation may preserve the alveolar anatomy, and the placement of a fixture in a fresh extraction socket helps to maintain the bony crest. Although a number of clinical studies exist, no histological reports show the outcome of implantation in fresh extraction sockets without the use of membranes in humans compared to implants placed in mature bone.

METHODS

Forty-eight healthy patients, receiving at least 4 fixtures in each of 2 symmetrical quadrants, underwent placement of 1 experimental fixture placed in a fresh extraction socket (TI) and 1 contralateral fixture in mature bone (CI). TI were placed after atraumatical tooth extraction, with a surgical site at the apex of the socket and a tight contact between the fixture and the socket's walls, but without the use of filling materials or membranes. The flap was coronally repositioned to obtain primary wound closure. Immediately after surgical intervention, a standardized periapical radiograph was taken. Second-stage surgery was done after 6 months. Six months after the second surgery, a second standardized periapical radiograph was taken and clinical parameters (bleeding and plaque index) recorded. Marginal bone loss (MBL) from the time of implant placement to the time of fixture removal was calculated by comparing periapical radiographs. TI and CI were then removed by a hollow drill to obtain histological specimens. Non-demineralized sections were stained by acid fuchsin and toluidine blue, and by von Kossa to evaluate the degree of bone mineralization. The percentage of direct implant-bone contact (DBC) was calculated by a computerized microscopic digitizer.

RESULTS

No significant differences in the clinical and radiographic parameters were observed between the 2 experimental categories. There was no statistically significant difference between TI and CI for DBC either in the maxilla or in the mandible. No connective or fibrous tissues were present around TI or CI. Bone resorption was not present in any of the histological sections.

CONCLUSIONS

The present study shows that when a screw-type dental implant is placed without the use of barrier membranes or other regenerative materials into a fresh extraction socket with a bone-to-implant gap of 2 mm or less, the clinical outcome and degree of osteointegration does not differ from implants placed in healed, mature bone.

Kaempferide triglycoside: a possible factor of resistance of carnation (Dianthus caryophyllus) to Fusarium oxysporum f. sp. dianthi

A kaempferide triglycoside has been found as a constitutive component in an uninfected carnation (Dianthus caryophyllus) of the cultivar Novada. The chemical structure has been determined mainly by the use of spectroscopic methods, including 2D NMR experiments. It showed a strong activity in restricting fungal parasite development, which could contribute to the known ability of carnation cv. Novada to resist to Fusarium oxysporum f. sp. dianthi infection.

[Intraoperative lesions of the maxillary artery and its immediate treatment. Presentation of a clinical case]

The authors discuss the possible vascular lesions that may occur during mandibular sagittal split ramus osteotomies with particular regard to the maxillary artery. A case of surgical lesion of the maxillary artery is presented and its course and anastomoses are analyzed. The ligation of the external carotid artery and its principal branches is the treatment of choice in case of maxillary artery lesion which is a life threatening event and needs immediate intervention.

[Registry of genetic and malformative diseases in the province of Macerata]

OBJECTIVES

The aim of this epidemiological research is to evaluate the prevalence of genetic diseases and malformative syndromes in paediatric population living in the Macerata county.

MATERIAL AND METHODS

All the data were collected through a careful analysis of a specific questionnaire sent to all the family paediatricians.

RESULTS

23,379 children living in Macerata county, aged 0 to 9 years, were evaluated (93.8% of all this paediatric population). Among those were found N 400 cases of genetic diseases and malformative syndromes: Malformations Tot.N. 255 cases (63.3% of the reported cases); Malformative Syndromes Tot. N. 55 cases (27.8% of the reported cases); Endocrinology and Metabolic Diseases Tot. N. 41 cases (10.3% of the reported cases); Osteochondrodysplasia Tot. N. 22 cases (5.7% of the reported cases); Other Tot. N. 28 cases (7.0% of the reported cases); Male population was found more affected than female: M/F ratio = 1.4. The analysis of the data showed an increasing trend in detecting these pathological conditions, consistent with the increase in geographic altitude (3 areas considered): 0-100 meter = 0.88%; 100-600 m.a.s. = 1.34%; over 600 m.a.s. = 1.88%.

CONCLUSION

The knowledge of the number of children affected by genetic and malformative diseases in the Macerata county is relevant in order to establish a Genetic Service with the aim to better support the medical assistance of these patients and counselling service for the families.

Comparison among 18 hexyl esters of 1-naphthylacetic acid used on grapevine

Eighteen esters derived from 1-naphthylacetic acid (NAA) and from hexyl isomer alcohols were synthesized and sprayed on grapevine suckers at 1, 2, 4, and 8% w/w concentrations to test their sucker control efficiency 2, 10, and 30 days and 1 year after their application. All compounds gave a prompt control of suckers. After 1 year, sucker growth was inhibited by the derivatives from primary and secondary alcohols, whereas the number of suckers was reduced only by application of naphthyl acetates of tertiary alcohols.

Immunocytochemical detection of hMSH2 and hMLH1 expression in oral SCC

BACKGROUND

The loss of DNA mismatch repair system was reported in hereditary non-poliposis colon cancer and in other tumours. The aim of this study was to detect the protein expression pattern of hMSH2 and hMLH1 in oral squamous cell carcinoma (SCC) by immunohistochemistry in paraffin-embedded tissues.

MATERIALS AND METHODS

5 specimens, obtained from healthy oral mucosa, and 20 from oral SCC were tested with anti-hMSH2 and anti-hMLH1 monoclonal antibodies.

RESULTS

Six cases (30%) showed nuclear positivity in differentiated areas (G1) and cytoplasmic positivity in areas with a lower degree of differentiation, four cases (20%) showed only cytoplasmic positivity, and only one (5%) no staining. One case of oral SCC (5%) showed no hMLH1 staining in the tumoral cells, even if normal squamous epithelium available in this section showed a nuclear positivity; six cases (30%) showed nuclear positivity in differentiated areas (G1) and cytoplasmic positivity in areas with a lower degree of differentiation, three cases (15%) showed only cytoplasmic positivity.

CONCLUSIONS

These data suggest that examination of hMSH2 and hMLH1 protein expression by immunohistochemistry is important in oral SCC. The analysis of mismatches expression in these cases of oral SCC might suggest that an absent nuclear staining for both hMSH2 and hML1 could constitute a hallmark of potential phenotype mutator for this type of neoplasia.

Nevoid basal cell carcinoma syndrome. Clinical findings in 37 Italian affected individuals

Nevoid basal cell carcinoma syndrome (NBCCS) is a hereditary condition transmitted as an autosomal dominant trait with complete penetrance and variable expressivity. The syndrome is characterised by numerous basal cell carcinomas (BCCs), odontogenic keratocysts of the jaws, palmar and/or plantar pits, skeletal abnormalities and intracranial calcifications. In this paper, the clinical features of 37 Italian patients are reviewed. Jaw cysts and calcification of falx cerebri were the most frequently observed anomalies, followed by BCCs and palmar/plantar pits. Similar to the case of African Americans, the relatively low frequency of BCCs in the Italian population is probably due to protective skin pigmentation. A future search based on mutation screening might establish a possible genotype phenotype correlation in Italian patients.