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The impact of bone marrow (BM) GD2-positive cells on survival has been evaluated in 145 Italian children with localised neuroblastoma (NB) evaluated at diagnosis by anti-GD2 immunocytochemistry. Nineteen of these (13.1%) were found to be BM GD2-positive, with the number of positive cells ranging between 1 and 155 out of 1 x 10(6) total cells analysed. Seven/19 (38.8%) GD2-positive vs 12/126 (9.5%) GD2-negative patients relapsed. The 5-year event-free survival (EFS) and overall survival of the GD2-positive patients was significantly worse than that of the GD2-negative ones (62.2 vs 89.9%, P<0.001; and 74.9 vs 95.9%, P=0.005, respectively). GD2 positivity was not associated to other known risk factors, and in particular to Myc-N amplification and 1p deletion. Among Myc-N-negative patients, the EFS of those negative for both GD2 and 1p deletion was significantly better than in children positive for either one of these two markers (EFS=96.9 vs 66.0%, P<0.001). In conclusion, GD2 positivity may represent a prognostic marker for patients with non-metastatic NB without Myc-N amplification, and its combination with genetic alterations might help identifying patients that require a more careful follow-up.

Aim: The aim of this study was to demonstrate how important neurological disorders are in the organization of services and education of staff in a pediatric emergency room. The first objective was to collect and review data in pediatric emergency care; based on an analysis of these data, the second objective was to design an organizational plan for emergency services to be developed in this setting., Methods: We used the ICD IX system to search our computerized database created in 2000 and to select diagnoses from the medical records of patients who came to our emergency room with neurological symptoms. Because the system is not yet comprehensive and because this was a retrospective study, we had to select the bulk of the diagnoses following the formulation each of us had given at patient discharge. While this raised the risk of data spread, it still permitted us to identify certain characteristics of the disorders that were particularly useful for classifying their etiopathogenesis., Results: Selected were 2.630 neurological patients that had been discharged or admitted to our unit (2.7% of all admissions). The patients were stratified by disorder and admission code number. Specific disorders of major impact, the clinical approach to their treatment and etiology were reviewed in detail., Conclusions: The results provide evidence that acute neurological disorders command the immediate attention of the emergency room physician and require prompt diagnosis.

The influence of two different electrode core temperatures on transcutaneous oxygen pressure (tcPO2) was studied in ten probands and 28 patients with peripheral arterial occlusive disease. Hyperaemisation of skin by an electrode core temperature of 44 degrees C reflects local hyperaemia flow and can be reproduced constantly. At 37 degrees C low tcPO2 values are recorded which are in good accordance with mathematically calculated capillary dome PO2. According to great physiological alterations in skin perfusion tcPO2 (37 degrees C) varies in wide ranges. This mode of measurement is well suited to study physiological autoregulation mechanisms or the influence of drugs on skin perfusion. The herein reported results are: forefoot tcPO2 (37 degrees C, 44 degrees C) in volunteers is significantly higher than in patients; forefoot tcPO2 (37 degrees C, 44 degrees C) of patients with diabetes mellitus is significantly higher than in nondiabetics; prestenotic tcPO2 (37 degrees C, 44 degrees C) is about two times higher than poststenotic tcPO2 (37 degrees C, 44 degrees C); tcPO2 (37 degrees C) in probands decreased significantly during occlusion of the venous circulation; tcPO2 (44 degrees C) increased in probands and patients when standing up; however, tcPO2 (37 degrees C) decreased in healthy persons and increased in patients when standing up; after a 5-min suprasystolic cuff occlusion of the arterial circulation there was a four- to six-fold increase of tcPO2 (37 degrees C) which indicates reactive skin capillary flow. In conclusion tcPO2 (37 degrees C) permits measurement of relative changes of skin capillary flow under physiological conditions so that autoregulating mechanisms can be studied.