Symptomatic seizures in preterm newborns: a review on clinical features and prognosis

Neonatal seizures are the most common neurological event in newborns, showing higher prevalence in preterm than in full-term infants. In the majority of cases they represent acute symptomatic phenomena, the main etiologies being intraventricular haemorrhage, hypoxic-ischemic encephalopathy, central nervous system infections and transient metabolic derangements.Current definition of neonatal seizures requires detection of paroxysmal EEG-changes, and in preterm newborns the incidence of electrographic-only seizures seems to be particularly high, further stressing the crucial role of electroencephalogram monitoring in this population. Imaging work-up includes an integration of serial cranial ultrasound and brain magnetic resonance at term-equivalent age. Unfavourable outcomes following seizures in preterm infants include death, neurodevelopmental impairment, epilepsy, cerebral palsy, hearing and visual impairment. As experimental evidence suggests a detrimental role of seizures per se in determining subsequent outcome, they should be promptly treated with the aim to reduce seizure burden and long-term disabilities. However, neonatal seizures show low response to conventional anticonvulsant drugs, and this is even more evident in preterm newborns, due to intrinsic developmental factors. As a consequence, as literature does not provide any specific guidelines, due to the lack of robust evidence, off-label medications are often administered in clinical practice

A salvage surgical solution for recurrent lymphangioma of the prepuce

Treatment of lymphangioma, circumscriptum of the prepuce is often technically demanding. Many different medical and surgical approaches have been described over the years, none of which has proved completely successful. We describe a case in which skin deficiency was a problem after prior multiple excisions of lymphangiomatous tissue. We decided to bury the degloved shaft in the scrotum. After 6 months the penis was raised and reconstructed using scrotal skin; this achieved satisfactory skin coverage. In such cases piliferous follicles can easily be dealt with at a later stage by cosmetic treatment.We believe this technical, approach may be a valid alternative to conventional procedures (i.e. grafts and flaps) especially when extensive resection makes skin coverage particularly difficult. (C) 2004 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved

Biogeochemical processes in sediments of the Manfredonia Gulf (Southern Adriatic Sea): early diagenesis of carbon and nutrient and benthic exchange

In order to understand the mechanisms responsible of the recycle of carbon and nutrients at the sediment-water interface and to understand the role of sediments in nutrients mass balance in coastal water, cores were collected (pore waters and solid phases) and benthic fluxes (oxygen, dissolved nutrients, dissolved iron and manganese, alkalinity and TCO2) were measured in two stations in the Gulf of Manfredonia (Southern Adriatic Sea). Stations were chosen to include a site, in the offshore part of the gulf, under the influence of western Adriatic current and another site, in the inner part of the gulf, under influence of gyres occurring inside the gulf. Both stations were placed in areas characterized by high sedimentation rate. Fluxes at sediment water interface show higher values in S2 site during the summer. Bio-irrigation seems to be the main transport mechanism characterizing both sites, with more evident effects during summer in S1 site

Carnitine palmitoyltransferase I in human carcinomas: a novel role in histone deacetylation?

Carnitine palmitoyl transferase I (CPT1) catalyzes the transport of long-chain fatty acids into mitochondria for beta-oxidation. A link between CPT1 and apoptosis has been suggested on the basis of several experimental data. Nevertheless, results are contradictory about the effective role of CPT1 in cell survival control and cancer development. Conversely, Fatty acid synthase (FAS) enzyme, required for the synthesis of fatty acids, is found over-expressed in tumors and inhibition of FAS triggers apoptosis in human cancer cells. We have studied the tumor-specific modulation of CPT1 and FAS in human colorectal cancer (n = 11) and breast carcinomas (n = 24). CPT1 was significantly decreased in the cytoplasm of tumoral samples (p < or = 0.04), whereas FAS was increased (p < or = 0.04). A striking CPT1 nuclear localization was evident in the tumors (p < or = 0.04). In the nuclear environment the protein would modulate the levels of acetyl/acyl-CoA implicated in the regulation of gene transcription. At this purpose, we performed in vitro experiments using epithelial neoplastic (MCF-7, Caco-2, HepG2 cells) and non neoplastic cell lines (MCF-12F) confirming a nuclear localization of CPT1 protein exclusively in neoplastic cells. Moreover histone deacetylase (HDAC) activity showed significantly higher levels in nuclear extracts from neoplastic than from control cells. HDAC1 and CPT1 proteins coimmunoprecipitated in nuclear extracts from MCF-7 cells. The treatment with HDAC inhibitors such as trichostatin A and butyrate significantly decreased nuclear expression of CPT1 and its bond to HDAC1. We also identified the existence of CPT1A mRNA transcript variant 2 in MCF-7, beside to the classic isoform 1. The peculiar localization of CPT1 in the nuclei of human carcinomas and the disclosed functional link between nuclear CPT1 and HDAC1 propose a new role of CPT1 in the histonic acetylation level of tumors

The sub-fossil red coral of Sciacca (Sicily Channel, Mediterranean Sea): colony size and age estimates

The Mediterranean red coral, Corallium rubrum (L.), has been a valuable economic resource for more than 2000 years. The Sicily Channel and surrounding areas are one of the most famous red coral fishing grounds of the whole region, hosting the deepest ever found living colonies and large sub-fossil red coral deposits; the so-called Sciacca banks are a unique location in the whole Mediterranean Sea. In this paper, a morphometric description of this sub-fossil population is presented for the first time from studies of colonies in the collection of several coral factories from Torre del Greco (Naples), with radiocarbon age estimations and growth rate evaluations. From the results of this study, after several thousand years Sciacca red coral colonies maintained the organic matrix structure with evident annual discontinuities, allowing estimations of the annual growth rate (about 0.3 mm/year) and the average population age (about 33.5 years). These resulting data are similar to the values determined for deep-dwelling living red coral populations. The radiocarbon dating evidenced a range of ages, from 8300 to 40 years before 1950 CE, mostly falling between 2700 and 3900 YBP, suggesting that colonies accumulated over a wide span of time. In view of the tectonically active nature of the area, several catastrophic events affected these ancient populations, maintaining them in a persistent state of early-stage, structurally similar to the those in current over-exploited areas

123I-Interleukin-2 scintigraphy for the in vivo assessment of intestinal mononuclear cell infiltration in Chron's disease

Activated mononuclear cells expressing interleukin-2 (IL2) receptors (IL2-Rs) heavily infiltrate the Crohn’s disease (CD) gut wall. A new technique for the in vivo detection of tissue infiltrating IL2-R positive (IL2R1ve) cells was developed based on 123I-IL2 scintigraphy. The aim of this study was to investigate whether 123I-IL2 accumulates in the CD gut wall in different phases of the disease and to evaluate the specificity of 123I-IL2 binding to activated IL2R1ve cells infiltrating the gut wall. Methods: Fifteen patients with ileal CD (10 active and 5 inactive) and 10 healthy volunteers were studied by 123I-IL2 scintigraphy. Six patients with active CD were studied before and after 12 wk of steroid treatment. After scintigraphy, patients were followed up for 29–54 mo. Ex vivo autoradiography was performed to determine specificity of 125IIL2 binding to IL2R1ve cells. For bowel scintigraphy, 123I-IL2 (75 MBq) was injected intravenously and g camera images were acquired after 1 h. Bowel radioactivity was quantified in 64 regions of interest (ROIs). Results: Autoradiography showed specific binding of 125I-IL2 to IL2R1ve mononuclear cells infiltrating the CD gut wall. Intestinal 123I-IL2 uptake assessed by the number of positive ROIs was higher in patients with active or inactive CD than in healthy volunteers (P , 0.0001 andP 5 0.03, respectively) and positively correlated with the CD activity index (P 5 0.01). 123I-IL2 intestinal uptake significantly decreased in patients with CD in steroid-induced remission (P 5 0.03). A significant correlation was observed between the number of positive ROIs and time to disease relapse. Conclusion: 123I-IL2 accumulates in the diseased CD gut wall by specific binding to IL2R1ve cells, infiltrating the involved tissues. 123I-IL2 scintigraphy may be an objective tool for the in vivo assessment of intestinal activated mononuclear cell infiltration

A respirable HPV-L2 dry-powder vaccine with GLA as amphiphilic lubricant and immune-adjuvant

Vaccines not requiring cold-chain storage/distribution and suitable for needle-free delivery are urgently needed. Pulmonary administration is one of the most promising non-parenteral routes for vaccine delivery. Through a multi-component excipient and spray-drying approach, we engineered highly respirable dry-powder vaccine particles containing a three-fold repeated peptide epitope derived from human papillomavirus (HPV16) minor capsid protein L2 displayed on Pyrococcus furious thioredoxin as antigen. A key feature of our engineering approach was the use of the amphiphilic endotoxin derivative glucopyranosyl lipid A (GLA) as both a coating agent enhancing particle de-aggregation and respirability as well as a built-in immune-adjuvant. Following an extensive characterization of the in vitro aerodynamic performance, lung deposition was verified in vivo by intratracheal administration in mice of a vaccine powder containing a fluorescently labeled derivative of the antigen. This was followed by a short-term immunization study that highlighted the ability of the GLA-adjuvanted vaccine powder to induce an anti-L2 systemic immune response comparable to (or even better than) that of the subcutaneously administered liquid-form vaccine. Despite the very short-term immunization conditions employed for this preliminary vaccination experiment, the intratracheally administered dry-powder, but not the subcutaneously injected liquid-state, vaccine induced consistent HPV neutralizing responses. Overall, the present data provide proof-of-concept validation of a new formulation design to produce a dry-powder vaccine that may be easily transferred to other antigens