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Background Recent studies have documented the complexity of the intestinal fungal community (‘mycobiome’) in mice, and clinical and experimental observations have shown that the mycobiome influences both gut health and disease, e.g., IBD. In fact, prior studies have shown that CD patients, compared to healthy controls, harbor higher levels of intestinal Candida tropicalis (Ct), which is the major fungal species detected in the colons of colitic mice after dextran sodium sulfate (DSS) challenge. Moreover, proteins encoded by genes within IBD susceptibility loci, such as the pattern recognition receptor (PRR), NOD2, are known not only to recognize bacterial components, but also a fungal cell wall element, chitin. In fact, the role of PRRs in regulating immunity against intestinal fungi, and how fungi influence IBD remains poorly defined. Methods We challenged DSS colitic wildtype (WT) and Nod2-/- mice with Ct 2 days before DSS administration and subsequently on day 0, 3 and 6. Bone marrow-derived macrophages (BMDMs) from untreated mice were administered chitin in vitro. Results Our data confirms previous studies that Ct challenge does not exacerbate colitis in DSS-treated C57BL/6 WT mice, however, Ct-infected Nod2-/- mice possess a higher fungal burden and exhibit worse colitis symptoms, such as weight loss, decreased stool consistency, and presence of blood in stools, vs. Ct-infected WT mice, indicating an essential and protective role for NOD2 during colitis recovery after Ct challenge. Our results also show that Ct-infected Nod2-/- mice display a marked reduction in colonic Il22 and Il17, which are cytokines previously reported to be important in maintaining epithelial barrier integrity during DSS colitis. These data were confirmed in colons of Ct infected DSS challenged, ileitis prone SAMP1/YitFc (SAMP) mice NOD2 deficient. Moreover, our in vitro data show, a decrease in Il1ß and Il23 in BMDM from SAMP Nod2-/- mice compared to WT after 2h of exposure to chitin. IL-17+ innate lymphoid cells (ILCs) are also known to control fungal burden during opportunistic fungal infections, and interestingly, our findings indicate that Ct infection of Nod2-/- vs. WT mice results in a decreased frequency of mesenteric lymph node–derived type 3 ILCs (ILC3s), suggesting that delay in fungal clearance and recovery in Nod2-/-mice may be due to the inability to mount protective type 3 immune responses. Conclusion Taken together, the data collected suggests that NOD2 is essential to maintain gut mycobiome homeostasis and drives protective innate immune responses, via a macrophage-mediated ILC3 recruitment and IL-17 mechanism, by preventing the overgrowth of opportunistic fungi that may contribute to chronic intestinal inflammation, such as that observed in CD.

Background Colorectal cancer associated to chronic colitis (CAC) has a different pathogenesis compared to sporadic or familial colorectal cancer and represents the major complication of IBD. IL-33 and its receptor, ST2, are important factors in the pathogenesis of IBD. Emerging evidence suggests the potential contribution to inflammation-driven tumorigenesis that can lead to CAC. The aim of our study was to characterize the precise contribution of IL-33/ST2 axis in the azoxymethane (AOM)/dextran sodium sulfate (DSS) model of CAC. Methods C57/BL6 wild-type (WT), Il33-/-, T1/St2-/- and Nt5e-/- mice were given a single dose of AOM followed by two cycles of 3% DSS for 7d in drinking water. Vehicle-treated WT mice served as controls and were sacrificed at the same time points. Another group of WT followed the same protocol and received CD73 inhibitor i.p. treatment or vehicle. Disease Activity Index, endoscopic, stereomicroscopic and histological evaluations of colons were performed. IHC, immunofluorescence (IF), qPCR, and ELISA were done on full-thickness colons. RNA-Seq was performed on whole tissues from AOM/DSS treated WT, Il33-/- and T1/St2-/-. qPCR analysis was done on isolated polyps from WT, Il33-/- and T1/St2-/- for Nt5e (CD73) and adenosine pathway targets. Results Il33, Ilrl1(ST2L), and Ilrl1(sST2) mRNA transcripts, as well as IL-33 and total ST2 proteins were dramatically elevated in AOM/DSS-treated WT mice vs. controls. IHC and IF of treated WT mice revealed localization of IL-33 to the colonic epithelium and to cells within the polyp LP morphologically consistent with stromal and mast cells. Using IF, IL-33 co-localized with sub-epithelial myofibroblast markers Actin and Vimentin, or with mast cell markers Tryptase and MCPT1. AOM/DSS treatment in Il33-/- and T1/St2-/- mice resulted in a significant decreased polyp number and size vs. WT, with colonoscopy revealing the development of protruding lesions with abnormal vascular patterns, suggesting tumorous lesions in WT mice, while all deficient mice showed their absence with a more impressive mucosal inflammation, likely due to reduced epithelial proliferation and repair caused by the deficiency of IL-33 signaling. RNA-Seq identified a significant reduction of Nt5e and adenosine pathway targets in Il33-/- and T1/St2-/-vs. WT. qPCR on isolated polyps confirmed this observation. AOM/DSS-treated Nt5e-/- showed a significant decreased polyp number and size vs. controls. Therapeutic inhibition of CD73 produced similar results. Conclusion Our results suggest that the IL-33/ST2 axis promotes tumorigenesis in CAC through the activation of CD73. Further studies are underway to determine mechanisms of action that support these findings.

This paper is a significant contribution to a general programme aimed to classify all projective irreducible representations of finite simple groups over an algebraically closed field, in which the image of at least one element is represented by an almost cyclic matrix (that is, a square matrix $M$ of size $n$ over a field $F$ with the property that there exists $\alpha\in F$ such that $M$ is similar to $diag(\alpha \cdot Id_k, M_1)$, where $M_1$ is cyclic and $0\leq k\leq n$). While a previous paper dealt with the Weil representations of finite classical groups, which play a key role in the general picture, the present paper provides a conclusive answer for all cross-characteristic projective irreducible representations of the finite quasi-simple groups of Lie type and their automorphism groups., Comment: To appear on Journal of Group Theory

Bubon macedonicum L. is a chasmophytic species of south-eastern Europe. In Italy, it has been detected only in Rocca Monforte (Campobasso, central Italy). This rare species is included in the IUCN Red Lists of Critically Endangered Italian Flora, and there are no studies relating to B. macedonicum biology. The seed germination dynamics of this species was studied with the aim of building up an appropriate germination protocol to be used in ex situ conservation. On the basis of an ISTA protocol, about 3,000 seeds were collected from Rocca Monforte in August 2013. Fifty seeds were measured. The considered parameters were seed length, width, thickness, seed surface, volume, density, surface/mass ratio and eccentricity index. The morphometric parameters examined showed morphological dormancy, where a short warm period is necessary for embryo growth and seed germination. The results showed high germination percentages under the different conditions of temperature, pH, GA3 and photoperiod. Only at 5 °C ...

Aiming at clarifying the discussed distribution of Iris marsica, endemic to central Italy, the authors tested the application of molecular techniques for the correct identification of this taxon, especially towards the similar, non-native I. x germanica. In fact, it was suspected that their morphological similarity would cause misidentification in the past, causing uncertainty of distributional data and consequently a weakening of conservation measures for I. marsica. After a comparison with the topotypical population of I. marsica, the authors found that DNA barcoding based on plastid sequences and nuclear microsatellites markers represents an effective identification tool, perfectly congruent with the preliminary morphological analyses and the chromosome counts. According to the results and despite some recent indications, I. marsica actually occurs also outside the National Park of Abruzzo, Lazio and Molise (central Italy), in further protected areas.

Inflammatory bowel disease (IBD) is associated with dysregulated macrophage responses, such that quiescent macrophages acquire a pro-inflammatory activation state and contribute to chronic intestinal inflammation. The transcriptional events governing macrophage activation and gene expression in the context of chronic inflammation such as IBD remain incompletely understood. Here, we identify Kruppel-like transcription factor-6 (KLF6) as a critical regulator of pathogenic myeloid cell activation in human and experimental IBD. We found that KLF6 was significantly upregulated in myeloid cells and intestinal tissue from IBD patients and experimental models of IBD, particularly in actively inflamed regions of the colon. Using complementary gain- and loss-of-function studies, we observed that KLF6 promotes pro-inflammatory gene expression through enhancement of nuclear factor κB (NFκB) signaling, while simultaneously suppressing anti-inflammatory gene expression through repression of signal transducer and activator of transcription 3 (STAT3) signaling. To study the in vivo role of myeloid KLF6, we treated myeloid-specific KLF6-knockout mice (Mac-KLF6-KO) with dextran sulfate sodium (DSS) and found that Mac-KLF6-KO mice were protected against chemically-induced colitis; this highlights the central role of myeloid KLF6 in promoting intestinal inflammation. Collectively, our results point to a novel gene regulatory program underlying pathogenic, pro-inflammatory macrophage activation in the setting of chronic intestinal inflammation.

This work aims to study seeds of the endemic species Astragalus aquilanus from four different populations of central Italy. We investigated seed morpho-colorimetric features (shape and size) and chemical differences (through infrared spectroscopy) among populations and between dark and light seeds. Seed morpho-colorimetric quantitative variables, describing shape, size and colour traits, were measured using image analysis techniques. Fourier transform infrared (FT-IR) spectroscopy was used to attempt seed chemical characterisation. The measured data were analysed by step-wise linear discriminant analysis (LDA). Moreover, we analysed the correlation between the four most important traits and six climatic variables extracted from WorldClim 2.0. The LDA on seeds traits shows clear differentiation of the four populations, which can be attributed to different chemical composition, as confirmed by Wilk's lambda test (P < 0.001). A strong correlation between morphometric traits and temperature (annual mean temperature, mean temperature of the warmest and coolest quarter), colorimetric traits and precipitation (annual precipitation, precipitation of wettest and driest quarter) was observed. The characterisation of A. aquilanus seeds shows large intraspecific plasticity both in morpho-colorimetric and chemical composition. These results confirm the strong relationship between the type of seed produced and the climatic variables.

Although genetic polymorphisms in NOD2 (nucleotide-binding oligomerization domain-containing 2) have been associated with the pathogenesis of Crohn's disease (CD), little is known regarding the role of wild-type (WT) NOD2 in the gut. To date, most murine studies addressing the role of WT Nod2 have been conducted using healthy (ileitis/colitis-free) mouse strains. Here, we evaluated the effects of Nod2 deletion in a murine model of spontaneous ileitis, i.e., the SAMP1Yit/Fc (SAMP) strain, which closely resembles CD. Remarkably, Nod2 deletion improved both chronic cobblestone ileitis (by 50% assessed, as the % of abnormal mucosa at 24 wks of age), as well as acute dextran sodium sulfate (DSS) colitis. Mechanistically, Th2 cytokine production and Th2-transcription factor activation (i.e., STAT6 phosphorylation) were reduced. Microbiologically, the effects of Nod2 deletion appeared independent of fecal microbiota composition and function, assessed by 16S rRNA and metatranscriptomics. Our findings indicate that pharmacological blockade of NOD2 signaling in humans could improve health in Th2-driven chronic intestinal inflammation.

The authors describe a rare case of primary ovarian fibrosarcoma and the latest trends in diagnosis and therapy. The rarity of this dis-ease and the scarce number of reported cases pose serious problems in differentiating it from other fibrous forms. A 58-year-old woman presented intermittent pelvic pain and a demarcated, mobile, and solid lump in the right adnexa. Diagnostic imaging revealed a solid- cystic inhomogeneous mass occupying the right adnexa and the CA125 level was elevated. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy. Histological findings with immunomarkers led to the final diagnosis of low-grade malignant mesenchymal neoplasm derived from the ovarian stroma compatible with fibrosarcoma. Twenty-four months follow-up showed no recurrence of disease. Ovarian fibrosarcoma is very uncommon neoplasm with a poor prognosis. Despite the efforts of several authors in reporting morphological, histological, and immunohistochemical features of this neoplasm, nowadays, the diagnosis, treatment, and prognosis are unresolved issues. The present case highlights the important role of immunohistochemistry to define histological type and differential diagnosis. As demonstrated by the authors' experience, they believe that surgery is curative in the early stages with low immunohistochemical positivity for ki67 and that chemotherapy should be reserved in advanced stages with regimens in use for the treatment of sarcomas.

Riassunto Gli effetti dell'antropizzazione diretta delle spiagge e delle dune costiere hanno portato non solo alla diminuzione ed estinzione locale di specie, ma anche alla diffusione di elementi esotici. Il presente lavoro espone i risultati preliminari sulla presenza di specie vegetali esotiche nei sistemi dunali olocenici dell'Italia centrale (Lazio, Abruzzo e Molise). Il censimento della flora vascolare esotica e stato effettuato seguendo il protocollo della cartografia floristica europea. E' emersa la presenza di una notevole diversita di entita esotiche distribuita nei diversi habitat della zonazione costiera psammofila. La maggior parte delle esotiche e di origine americana, anche se alcune differenze emergono dal confronto fra i due litorali considerati: su quello tirrenico si rinvengono con maggior frequenza le specie di origine tropicale mentre su quello adriatico le specie aliene sono prevalentemente di origine extra-tropicale. Delle numerose specie rinvenute ed esaminate la maggior parte sono ...

The main result of this paper is a graph-theoretic necessary and sufficient condition, for a given set of transvections in SL(n, K) (n > 2 and K a finite field of characteristic not 2 or 3), to generate a group isomorphic to SL (m, L), for some m and some subfield L of K.

Let R be a ring with 1 and En (R) be the subgroup of GLn(R) generated by the matrices I + reij, r ∈ R, i ≠ j. We prove that the subgroup of consisting of the matrices of shape , where and , is (2, 3, 7)-generated whenever R is finitely generated and n, are large enough.

The ex situ conservation of biodiversity is an essential tool for environmental protection interventions. Germination studies of seeds that belong to endangered species are essential for ex situ conservation strategies. In this study, we investigate the germination responses of three high-altitude endemic and vulnerable species (Leontopodium nivale, Pinguicula fiorii and Soldanella minima subsp. samnitica). Specifically we identified potential dormancy mechanisms by investigating the responses of germination percentage and rate to different concentrations of gibberellic acid (GA3), by performing a general linear model. L. nivale reached a germination percentage of 98.0 ± 2.0% (mean ± SE) under control conditions (20°C; 12/12 photoperiod; no GA3 addition). P. fiorii showed the highest germination percentage (78.0 ± 2.0%) in the treatment with GA3 500 ppm. S. minima subsp. samnitica did not show sensitivity to GA3 but responded positively to cold stratification (6 month at 5°C) with a germination percentage...

To evaluate the effects of infection in multiple types of high-risk human papilloma virus (HPV) in cervical preneoplastic lesions in patients undergoing colposcopy following a diagnosis of atypical squamous cells of unknown significance (ASCUS) and low-grade squamous intraepithelial (LSIL) cytology.Between 2009 and 2010, 2,500 patients were recruited with a mean age of 35 +/- 5 years. Screening for cervical cancer was performed and in case of ASCUS and LSIL the patients underwent colposcopy. The tests for the detection and typing of viral DNA (HPV - DNA test) were performed on cervical swab with real-time PCR amplification.The prevalence of infection was 70% (1579/2256) in the patients recruited. In relation to the degree of preneoplastic lesions some high-risk HPV viral genotypes were identified: HPV 16 (319/1466), HPV 18 (164/1466), HPV 45 (76/1466), HPV 31 (215/1466), HPV 52 (145/1466), HPV 58 (55/1466) HPV 56 (79/1466), HPV 51 (110/1466), HPV 6(138/1466), HPV 11 (88/1466), HPV 42 (34/1466), HPV 53 (43/1466). In case of high-grade lesions of CIN (CIN2 and CIN3) a greater HPV co-infection was detected and in particular the association from 16 to 18 (70%), 16-33 (18%) and 16 to 52 (12%).Infection caused by the simultaneous presence of multiple HPV genotypes appears to be associated with a significantly increased risk of high-grade lesions of CIN or invasive cancer than the presence of single viral infections. The infection with multiple HPV types is a significant risk factor for high-grade lesions of CIN in women undergoing colposcopy for ASCUS cytology/LSIL. The use of real-time PCR has shown the ability not only to identify the different types of HPV, but also to monitor quantitatively the same over time, and during the study phase, to evaluate the sensitivity and specificity of the method in comparison with other techniques.

Let G be a finite quasi-simple group of Lie type of defining characteristic r > 2. Let H = 〈h, G〉 be a group with normal subgroup G, where h is a non-central r-element of H. Let ϕ be an irreducible representation of H non-trivial on G over an algebraically closed field of characteristic ℓ ≠ r. We show that ϕ(h) has at least two distinct eigenvalues of multiplicity greater than 1, unless G is a central quotient of one of the following groups: SL(2, r), SL(2, 9) or Sp(4, 3), and H = G⋅Z(H).

A phytosociological study of the alliance Carpinion orientalis in the hilly and subcoastal areas of the Italian peninsula is presented. These woods are included in the suballiances Laburno-Ostryenion and Lauro-Quercenion; the distinction between these two suballiances is not always easy also because of the conservation status of these forest ecosystems. The hilly and subcoastal Turkey oak woods of the alliance Carpinion orientalis are mainly distributed on the Adriatic side of the Italian peninsula, where they are found on neutro-basic substrata to which these coenoses are linked. The Turkey oak woods of the alliance Teucrio siculi-Quercion cerridis are strongly linked to the acidic substrata typical of the Tyrrhenian side, but are sporadically found on the Adriatic side within small enclaves with more acidic substrata. A numerical analysis allowed us to rearrange the lower hierarchical levels of the associations of Turkey oak woods of the alliance Carpinion orientalis. In particular, the association Lonicero xylostei-Quercetum cerridis is included in the alliance Carpinion orientalis, and the new subassociation festucetosum exaltatae is proposed. The subassociation rosetosum arvensis is proposed for the association Daphno laureolae-Quercetum cerridis, and the new subassociation cytisophylletosum sessilifolii of the association Aceri obtusati-Quercetum cerridis is described.

Hepatitis viruses and the acquired immunodeficiency viruses often infect intravenous drug addicts (IVDAs). Our study includes 255 IVDAs (26 females and 229 males, aged 20-35 years) from Cagliari. Of 255 subjects examined, 207 (81.1%) were positive for anti-HCV and 84 (32.9%) for anti-HIV. Nineteen (7.4%) subjects were HBsAg carriers, and 12 of these (63%) had an HDV superinfection. Markers of previous HBV infections were tested in 223 cases and 137 (61.4%) were found positive; of these 14 (10.2%) also had HDV infection. Of the 223 drug addicts examined for all infection markers, 18 (8%) were negative to all markers, 46 (20.6%) were positive to only one, 89 (39.9%) were positive to two, 64 (28.7%) to three and 6 (2.6%) were positive to all. Subjects with a single infection were significantly fewer than those with multiple infections. The correlations studied among the various markers did not point out any statistically significant associations. Even so, a previous HBV infection was more common while active HBV/HDV infections were less common among subjects with anti-HCV; HDV infection was more common among HIV-positive subjects. In HBsAg carriers neither HBV-DNA nor HCV-RNA was detected; HCV-RNA was found more frequently in anti-HIV positive subjects than in subjects with the anti-HCV isolate.

To evaluate feasibility, tolerability and cosmetic outcome of intra-operative radiation therapy (IORT) as an exclusive post-surgery treatment of early stage breast cancer.From October 2008 to October 2009 30 patients underwent wide breast cancer excision or quadrantectomy followed by IORT on tumor bed with accelerated electrons at the dose of 21Gy. The characteristics of the patients were: ductal breast cancer or invasive lobular cT1, cT2 ≤ 2,5 cm, cN0, G1-2, age over 35 years, M0.The average age was 51.7 (range 38 - 75) with an average follow up of 11.7 months (range 6 - 18). The pathologic stage of the lesions resulted pT1 in 29 cases (96,6%), in particular: one case pT1a (3,3%), 21 cases pT1b (70,0%) and 7 cases pT1c (23,3%). One case (3,3%) was pT2 with a diameter of 2.5 cm. The grading was G2 in 20 cases (66,6%) and G1 in 10 cases (33,3%). The toxicity, evaluated according to the EORTC-RTOG criteria, was G0 (33.3%) in 10 cases, G1 (63,3%) in 19 cases, G2 in one case (3,4%); there was no G3 toxicity. The time needed for a complete healing of the wound was less than 10 days in 96,7% of the cases, with one case of limphocele (3,3%). There were no infections of the surgical wound nor any mastitis, neither in the treated quadrant nor in the other ones. We observed a light fibrosis in 5 cases (16,6%), moderate in 2 cases (6,6%) but never severe. Cosmetics, evaluated in four levels, according to Danoff et al., was excellent in 3 cases (43,3%), good in 15 cases (50%), sufficient in 2 cases (6,7%), never insufficient. As regards local control, there was no local relapse. The global survival was 100%.The IORT in early breast cancer, at the doses used in this study, proved itself as a secure technique, repeatable, with limited complications. The advantages of its use are the possibility of a direct control, by the surgeon and the radiotherapist, of the structures to treat and those to protect; the absence of time needed for cellular repopulation between surgery and radiotherapy; a good cosmetic outcome; and logistic advantages. It is necessary to have a long term follow up to evaluate the efficacy in terms of long term cosmetic and local control.

Tautomerisme amidine-enediamine: addition d'isocyanates a des 1H-perimidines substituees en 2. Quelques syntheses sous irradiation micro-ondes. La C-addition electrophile et regioselective des isocyanates 4 au 1H-perimidine-2-acetate d'ethyle 3a et au 1H-perimidine-2-acetonitrile 3b est etudiee et permet d'acceder a de nouvelles ene-diamines heterocycliques 5'a-j avec des rendements variant de 60 a 94 %. Les spectres RMN 1 H et 13 C de ces composes sont discutes. Leur structure comporte une double liaison exocyclique qui est fortement polarisee par un effet «donneur-accepteur». Le 2-methyl-1H-perimidine-2-acetate d'ethyle 3c ne donne aucune reaction avec l'isocyanate d'ethyle 4a. La synthese de quelques composes 5' sans solvant sous irradiation micro-ondes ou au bain d'huile est decrite.

We study a class of finite p-groups admitting faithful irreducible complex representations of distinct degrees. In particular, for every prime p, we produce an example of such a p-group having minimal order p 8.

In this paper we prove that the (non-trivial) irreducible complex unipotent characters of a finite classical group G of type Bm or Cm in odd characteristic are reducible over any proper subgroup of G, apart from very few notable exceptions.

This note is an addendum to the paper “Minimum polynomials and lower bounds for eigenvalue multiplicities of prime-power order elements in representations of classical groups” [J. Algebra 243 (2001) 228–263], providing a correct full statement and proof of Theorem 1.1 in that paper, and thus yielding a complete classification of the triples (G, g, theta), where G is a quasi-simple classical group, g is a semisimple element of G of prime-power order belonging to a parabolic subgroup, and theta is a representation of G in cross-characteristic, in which the degree of the minimum polynomial of g is ‘exceptional’. This result can be viewed as an analogue of the celebrated Hall–Higman theorem in the context of quasi-simple classical groups.

In the first half of the 20th century, visceral leishmaniasis (VL) was a common infantile syndrome in coastal territories of the Campania region of Italy. After World War II, the incidence dropped to a few cases/year for three decades; in late 1980s the disease reemerged among both children and adults. To face the VL recrudescence, a Paediatric Reference Centre was established at the Santobono-Pausilipon hospital in Naples, for the clinical diagnosis, care and drug treatment of all infantile VL cases occurred in the Campania region. Rapid laboratory diagnosis was secured by a Diagnostic Reference Centre established at the Istituto Superiore di Sanità. Here, we report on the epidemiological and parasitological features of all cases referred to the Centre in the past 15 years. From 1990 to March 2004, a total of 255 cases were diagnosed and treated at the Centre. The Figure shows the yearly trend of patients (min. 3 cases in 1990 and 1991, max. 30 cases in 2000). There were 135 males (52.9%); the age ranged 4 months-14 years, but 189 patients (74.1%) wereor = 3 years old. The majority of the patients (189, 74.1%) were from the Naples province, with a cluster of 102 cases (40% of total patients) from the towns and districts surrounding Vesuvius. Twenty-seven cases (10.6%) were from the town of Maddaloni, Caserta province, whereas 15 cases (5.9%) were from coastal villages of the Salerno province. Only 1 and 2 cases were from Benevento and Avellino provinces, respectively. All patients but seven, who have been treated with antimonial drugs in the 1990-1993 period, were successfully treated with a liposomal amphotericin B regimen. From bone-marrow aspirate samples, 138 Leishmania cultures were obtained in EMTM and Sloppy Evans' media, of which 134 have been typed by the electrophoretic analysis of 13 isoenzymes. Two zymodemes (Z) of L. infantum were routinely identified over the study period, ZMON-1 (the commonest zymodeme in the Mediterranean area) and ZMON-72, variant from MON-1 in PGM mobility and detected only in our region. The latter, identified in 61 patients (45.5%), was found exclusively distributed in towns of the Vesuvius area and in Maddaloni until 1996, but in recent years it appears to have spread to other areas of the Naples (including the island of Ischia) and Caserta provinces, but not to Salerno province. In conclusion, the VL macrofocus of the Naples-Caserta area is probably responsible for the highest number of infantile cases among any VL macrofoci described in southern Europe. Considering the limited efforts paid to control the canine reservoir, rapid diagnosis and appropriate treatment of patients still remain the first-line control measures aimed at reducing the health impact of the disease.

The match between ticks and pediatricians in Italy is usually a seasonal event related to the spring and summer trips and to the increasing of outdoor activity that sun and warm weather allow, both for children and ticks. So cared parents reach emergencies asking for tick removal but more often after the tick has yet been removed by empirical manoeuvres and after the killing and the destruction of the "enemy". We have scheduled, in the years 2002-2003, the 167 children that reached our unit for a tick bite; they where 92 males (mean age four years) and 75 females (mean age five years). Two of them had only a questionable tick bite but one had erythema on the lateral side of the left ankle, fever of obscure origin and weakness with generalised malaise. She was six years old and she lived with a dog on which, in more instances, ticks where found, but she never noticed ticks on her body. The dog had positive levels of anti rickettsial and anti borrelia antibodies but no evidence of conclamate illness. In this girl we found high titers of anti borrelia antibodies that WB testing confirmed to be anti B. burgdoferi. We diagnosed Lyme disease and treated the girl with amoxicillin (50 mg/kg/day) for three weeks achieving the complete relief of symptomatology till today. Three children with conclamate tick bite had positive levels of anti Rickettsia conorii antibodies with increasing levels at a twenty days control; two (aged four and five years) of them had a full symptomatology (tache noire, satellite lymphadenopathy, fever, and maculopapular erythema) for Meditarranean spotted fever; the latter (three years old) had an atypical form with the complete absence of maculopapular erythema. The therapy was clarithromycin (15 mg/kg/day) for three weeks. In Campania, in the years 2002/2003 on 167 children with tick bite that reached our unit, we found only four pathological correlable events; so are our ticks not infected? But we don't know how many children where tick bited and if there were other children with Lyme disease or Rickettsial disease because of the lack of a pediatric reference centre for "tick bite diseases" and the incomplete and late diffusion of knowledge on these diseases. Other Italian regions and such as Trentino Alto Adige, Veneto, and Friuli Venezia Giulia had a remarkable officially notified number of cases of Lyme disease and in Sicilia, Sardegna and Lazio there were numerous officially notified Rickettsial diseases. So we hope that Campania may be an happy island but we also think that a more effective cooperation between pediatricians and veterinarians and the creation of regional reference centres for tick bite diseases may arise a surveillance net to prevent the diffusion of these world wide emerging diseases and so that parents can achieve an univoque and useful information, the only way to defeat the fear of ignorance.

We describe a case of TBC spinal column infection complicated by vertebral abscesses in an immigrant teenager. We underline the importance of always suspecting a tubercular illness when fever has unknown origins, and when patients come from countries where TBC is still endemic. We reaffirm, for early and accurate diagnosis, the importance of abdominal echography and spinal tomography.

Thanks to a retrospective analysis of the first 250 cases of sentinel lymph nodes in breast cancer assessed by the authors over the period from October 1998 to December 2000 in the light of a careful review of the literature, it has been possible to establish the importance of careful patient selection, strict compliance with the execution technique and, above all, the need for an adequate learning curve, before the procedure is used in particular protocols and/or in routine clinical practice in the near future. In particular, the training should first of all ensure that all personnel involved, i.e. surgeons, nuclear medicine specialists, and histopathologists, should attend specific courses at qualified Institutions followed by the actual management of a certain number of consecutive cases. In order to perfect the methodology and organisation, a preliminary study in a group of patients at different stages of evolution of the disease is recommended (50 cases in the study population reported). The next phase should include a group of highly selected patients, numbering at least 50-100. The training may be considered complete when in at least 20 cases, an identification rate of at least 90% is achieved with an incidence of false negatives of not more than 5%. In the authors' experience, these results were reached after 100 selected patients, and were later consistently confirmed after a further 50 cases.

The prognosis of soft tissue sarcomas has dramatically improved over the past few decades thanks to the use of increasingly suitable multidisciplinary therapeutic approaches. An assessment of the results of our series of 21 patients, carried out in the light of the most recent literature data, has led us to revise our approach to a number of problems regarding the natural history, the nosographical classification and the therapy of these cancers. This type of tumour arises in a muscle compartment and then spreads proximally and distally within the compartment without involving adjacent structures, except in a relatively advanced phase, while as regards remote metastases the preferential diffusion route is via the bloodstream. Thorough assessment of the clinical and morphological characteristics is essential for adequate treatment: echotomography, CT, and MRI are particularly useful in preoperative staging; a microscopic examination should always include precise classification and accurate assessment of the tumour grade. Surgical management consists in extensive en bloc resection, followed by radiotherapy in the event of unclear margins and/or high grade tumour even when dealing with small sarcomas. The main indications for chemotherapy are locally advanced cases or cases with distant metastases. Thanks to these therapeutic approaches today, good results can be achieved, with 5-year survival rates of 80 and 67%, respectively, in stages I and II, and of 12 to 50% in the more advanced stages.

The case of a 3-year-old female with an atypical presentation of foreign body aspiration is described. Resistance to the therapy, mild radiological signs and a high index of suspicion of the clinician could lead to the right diagnosis.

We evaluated liposomal amphotericin B (AmBisome; Vestar, San Dimas, CA) administered to 88 immunocompetent patients (56 children) with visceral leishmaniasis (VL) caused by Leishmania infantum. Thirteen patients received 4 mg/kg on days 1-5 and 10 (total dose, 24 mg/kg), and all were cured; 42 received 3 mg/kg on days 1-5 and 10 (18 mg/kg), and 41 were cured; 32 received 3 mg/kg on days 1-4 and 10 (15 mg/kg), and 29 were cured (amastigotes were not cleared from 1 child, and 2 relapsed). One adult was cured with a total dose of 12mg/kg. The four children who were not cured received 3 mg/kg for 10 days; none had further relapses. There were no significant adverse events. For VL due to L. infantum, we recommended a total dose of AmBisome of > or = 20 mg/kg, given in > or = 5 doses of 3-4 mg/kg over > or = 10 days.