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Biomedical subjects

C Esposito

Publications and source records attributed to C Esposito.

At least 91 records · Page 5Linked to original sources
PubMed1997

Transumbilical open laparoscopy: a simple method of avoiding complications in pediatric surgery

The author reports his experience with a new procedure, transumbilical open laparoscopy (TUOL), to obtain the pneumoperitoneum in children operated upon laparoscopically. TUOL was designed to avoid complications related to closed introduction of the first trocar, and consists in the visually-guided introduction of the first trocar transumbilically without any need for a pursestring suture, with an operative time of about 1 min. The author recommends TUOL as it is easier, less expensive, and less time-consuming compared to other techniques.

Journal Article↗
PubMed1997

Cell-cycle kinetics of Friend erythroleukemia cells in a magnetically shielded room and in a low-frequency/low-intensity magnetic field.

This work was undertaken to compare the behavior of Friend erythroleukemia cells in a solenoid, where the magnetic field was 70 microT at 50 Hz (plus 45 microT DC of Earth) with that of the same cells in a magnetically shielded room, where the magnetic field was attenuated to 20 nT DC and 2.5 pT AC. The control laboratory magnetic field corresponded to 45 microT DC and a stray 50 Hz field below 0.2 microT. The culture growth cycle of cells maintained inside the solenoid was slightly accelerated compared with that of cells maintained outside the solenoid (P < .05). This stimulation probably depended on sensitivity of cell cycle to a magnetic field, because, inside the solenoid, the percentage of G1 cells slightly increased during the culture growth cycle, whereas that of S cells slightly decreased. Acceleration of growth was detected soon after exposure of the cultures to the solenoid field, and growth did not change further if the action of this field continued for a long time, accounting for adaptation. The solenoid field also caused a small increase of cell survival without influencing cell volume. By contrast, the culture growth cycle of cells maintained inside the magnetically shielded room was slightly decelerated compared with that of cells maintained outside the room (P < .05). The essential absence of any field inside the magnetically shielded room also caused a small increase of cell volume, whereas, during the culture growth cycle, the percentage of G1 cells decreased, and that of S cells increased. The majority of these events did not change in cells induced to differentiate hemoglobin through dimethylsulfoxide.

Animals↗
PubMed1997

Pediatric laparoscopic splenectomy: are there real advantages in comparison with the traditional open approach?

The hospital records of patients who underwent splenectomy during the last 2 years were reviewed to compare the advantages of the laparoscopic approach with traditional open splenectomy (OS). Between March 1994 and March 1996, 16 children underwent splenectomy, in 8 using an open approach and 8 by a laparoscopic procedure. Of the patients who underwent laparoscopic splenectomy (LS), 2 had a concomitant cholecystectomy. Ages ranged between 4 and 11 years (mean 6.4 years); there were 9 girls and 7 boys. The indications for splenectomy were: hereditary spherocytosis (7 cases); idiopathic thrombocytopenic purpura (4); sickle-cell disease (3); and beta-thalassemia (2). The average operating time for OS was 100 min (range, 50-155), for LS 170 min (range 125-240). The hospital stay for patients who had OS ranged from 3 to 9 days (mean 4.7), for those who had LS from 2 to 5 days (mean 3). One OS patient developed a wound infection. In 3 of the LS patients, the spleen was removed via a 7-cm Pfannenstiel minilaparotomy in the suprapubic region; in 5 cases the spleen was captured into an extraction bag, crushed, and removed through the umbilical orifice. The authors believe that LS must be performed only when it is possible to use the extraction bag to remove the spleen from the umbilical orifice (spleens weighing less than 700 g) and when a concomitant procedure such as cholecystectomy is indicated; in other cases OS is preferable.

Child↗
PubMed1997

Complications of pediatric laparoscopic surgery.

BACKGROUND: Surgical complications of laparoscopy most often occur during Veress needle or primary trocar placement. Veress needle punctures are insignificant and require no further treatment, whereas trocar-induced vascular injuries can be catastrophic. The frequency of vascular and viscus injuries is difficult to calculate because several complications are not reported in the literature. METHODS: During a 10-year-period (1984-1995), at the Division of Pediatric Surgery at "Federico II" University of Naples, 430 laparoscopic procedures were performed in 395 children with a mean age of 5 years. The incidence of complications related to laparoscopy was 1.8% with eight complications, one of which was rather severe. The complications included one abdominal wall hematoma, two perforations of abdominal viscus (stomach, ovary), one umbilical scar complication, one postoperative hydrocele, one subcutaneous emphysema, and one pneumothorax during a Nissen procedure. The only severe complication occurred in a young girl with neurologic problems and a kyphoscoliosis operated on via laparoscopy for a gastroesophageal reflux. She suffered injuries of both right common iliac vessels and several intestinal perforations due to blind introduction of the first umbilical trocar. RESULTS: In this case rapid conversion, complex vascular reconstruction, and multiple intestinal sutures were performed. The Nissen fundoplication with pyloroplasty was performed traditionally and the patient left the hospital free of symptoms after 20 days. The other seven complications were resolved without any problem intra- or postoperatively. CONCLUSIONS: The authors believe that the open approach with a blunt trocar is most important in helping to avoid complications in pediatric laparoscopy.

Adolescent↗
PubMed1997

The value of 2-step laparoscopic Fowler-Stephens orchiopexy for intra-abdominal testes.

PURPOSE: We report our experience in the treatment of high intra-abdominal testis with a complete laparoscopic 2-stage Fowler-Stephens procedure with associated transperitoneal closure of the internal ring in pediatric patients. MATERIALS AND METHODS: Between 1990 and 1997, 100 boys with 105 nonpalpable testes underwent laparoscopy. Laparoscopy showed intra-abdominal testis in 40 cases. In 5 cases when the testis was just proximal to the internal ring, we performed standard orchiopexy. In 35 cases with the testis in the high intra-abdominal position, we performed the Fowler-Stephens procedure with the first stage performed laparoscopically. To date, all 35 testis have undergone the second phase after 6 to 12 months (2 by open technique, 33 by laparoscopy). The last 33 patients underwent the second phase of the 2-stage Fowler-Stephens procedure by laparoscopy with associated video surgical transperitoneal closure of internal ring. RESULTS: All testes were successfully placed in the scrotum. At a mean 30 months of followup, with clinical examination, ultrasonography and comparative colorimetric echo Doppler study, all testes were viable in the scrotum, except for 1 that became atrophic 2 months after the second open phase of 2-stage Fowler-Stephens technique. CONCLUSIONS: Our early results suggest that the 2-stage Fowler-Stephens procedure, performed completely using laparoscopy, is a feasible technique for treating high intra-abdominal testis.

Child↗
PubMed1997

Transglutaminase-synthesized spermine derivative of substance P recognizes rat portal vein neurokinin-3 receptors.

The effects of the transglutaminase-synthesized polyamine derivatives of Substance P (SP) have been further characterized by their ability to contract in vitro the rat portal vein strip (RPV), a pharmacological preparation particularly rich in NK-3 receptors. The effects of selective agonists of NK-1, NK-2 and NK-3 receptors [Sar9,Met(O(2))11]SP, beta-Ala8 NKA(4-10), and senktide respectively, were also evaluated by measuring RPV concentration-response curves. Peptide [GR-82334 (NK-1) and MEN-10,376 (NK-2)] and nonpeptide [WIN 51,708 (NK-1) and SR 142801 (NK-3)] NK receptor antagonists were used to confirm the participation of the different NK receptors to contractile response. Our results demonstrated that the spermine derivative of SP (Spm-SP), previously shown to be unable to recognize NK-1 and NK-2 receptors in some bioassays, contracts RPV (EC50 = 588 nM) better than the native neuropeptide (EC50 = 1120 nM). A pretreatment with thiorphan, an inhibitor of neutral endopeptidases, significantly reduced such a difference. While this inhibitor shifts the SP concentration-response curves to the left (EC50 = 720 nM) the action of Spm-SP and [Sar9,Met(O(2))11]SP were completely thiorphan-resistant. In the absence of thiorphan we found the following rank order of potency: senktide > > beta-Ala8 NKA(4-10) > [Sar9,Met(O(2))11]SP = Spm-SP > SP. Among the mentioned NK receptor antagonists, only the selective NK-3 receptor antagonist, SR 142801, shifted to the right Spm-SP and [Sar9,Met(O(2))11]SP concentration-response curve, showing pKB values of 5.84 and 5.88, respectively. Therefore, the reported results suggest that the introduction of a Spm moiety into the SP alters the parent peptide molecule by increasing its affinity for NK-3 receptors and/or by preventing its degradation by some proteolytic enzymes.

Androstanes↗
PubMed1997

The in vitro effect of hydroxychloroquine on skin morphology and transglutaminase.

BACKGROUND: Antimalarials are some of the most notorious drugs which may induce psoriasis, with 25% of all reported cases being associated with them. Antimalarials do not induce psoriasis de novo, but trigger subclinical psoriasis. In a previous report, we suggested that antimalarials exert their effect by interfering with the epidermal transglutaminase (TGase) activity. OBJECTIVE: To verify this hypothesis by examining the effect of hydroxychloroquine sulfate (HCQS) on cultured human skin and on TGase activity in vitro. MATERIALS AND METHODS: Skin samples from normal donors were cultured in the presence of HCQS for 4 days, and then processed for microscopic examination. TGase activity was assayed in the presence of HCQS and compared with blanks. RESULTS: Significant changes in epidermal morphology were seen in all explants cultured in the presence of HCQS at all concentrations employed. Areas of enhanced and irregular keratinization were observed in the upper epidermis, while a loss of cell polarity, with keratinocyte crowding and disarray, was seen in the lower epidermis. In addition, we observed intraepidermal splitting at different levels and dermo-epidermal detachments. HCQS showed a concentration-dependent inhibition of TGase activity. CONCLUSIONS: We suggest that HCQS causes an initial break in the barrier function of the epidermis by inhibiting TGase activity; this is followed by a physiologic response of the epidermis aimed at barrier restoration. This rather nonspecific stimulus to epidermal proliferation is probably sufficient to trigger psoriasis in predisposed individuals or aggravate it in psoriatic patients.

Antimalarials↗
PubMed1997

Laparoscopy-guided biopsy in diagnosis of liver disorders in children.

To determine the safety and advantages of laparoscopic liver biopsy in pediatric liver disorders, we reviewed the medical records of 80 children affected by liver disease of various etiologies who underwent this procedure from 1986 to 1996. The main indicators for laparoscopic biopsy were increased risk of bleeding (i.e., mild to moderate coagulation abnormalities in patients probably affected by cirrhosis) and/or previous poorly informative blind needle liver biopsy (65 cases), and the need for a large amount of liver tissue for biochemical assays (10 cases). After inspection of the liver surface, at least two core biopsies were performed using a Tru-cut needle. We encountered difficulties with the biopsy in only four cases, due to a hard consistency of the liver. Bleeding time from the liver orifice was greatly reduced by positioning a fibrin plug (50-120 s vs 5-10 s, on average). In 15 patients, a large excisional biopsy was also successfully performed. Our results confirm an important role for laparoscopy in the diagnosis of cirrhosis (30% of bioptic false negative diagnoses in this series) and show that in selected cases laparoscopy-guided needle or excisional biopsy is an easy, useful and safe alternative to percutaneous blind liver biopsy.

Adolescent↗
PubMed1997

Circulating serum lectins of patients with IgA nephropathy stimulate IL-6 release from mesangial cells.

Previously, the authors reported that the serum of patients with immunoglobulin (Ig) A nephropathy stimulated peripheral leukocytes, and this effect was inhibited by nominal haptens for lectins. In vitro studies have shown that lectins can bind to rat mesangial cells and cause their activation. This study was performed to investigate whether the serum of IgA nephropathy patients contains lectins that activate mesangial cells, i.e., induce release of interleukin (IL)-6, a nephritogenic cytokine. The serum of patients was adsorbed by affinity chromatography on resins loaded with lectin-binding sugars. After adsorption, serum supernatant was collected and the resins were then eluted. Human mesangial cells were conditioned with native serum, post-adsorption supernatant, and eluate (all three at 10%) for 24 h, and the release of IL-6 was determined by ELISA. Normal serum was used as control. Incubation of mesangial cells with IgA nephropathy patients serum raised average IL-6 release from 8.5 pg/mL to 274.1 pg/mL. Adsorption in beta-D-glucose and N-acetyl-D-glucosamine caused a fall in the activity of patients' serum, to 17.0 and 63.7 pg/mL, respectively, and the activity lost was recovered in the eluate (185.2 and 142.7 pg/mL, respectively). Neither adsorption on N-acetyl-D-galactosamine nor on fucosylamine was associated with any effect on serum activity; accordingly, no activity was found in the eluates. Serum of patients with non-IgA mesangiocapillary nephritis did not stimulate mesangial cells. These results show that the serum of IgA nephropathy patients contains specific lectins that stimulate IL-6 nephropathy by mesangial cells and are, therefore, potential nephritogenic.

Adult↗
PubMed1997

Transumbilical open laparoscopy: a simple method of avoiding complications in pediatric surgery.

The author reports his experience with a new procedure, transumbilical open laparoscopy (TUOL), to obtain the pneumoperitoneum in children operated upon laparoscopically. TUOL was designed to avoid complications related to closed introduction of the first trocar, and consists in the visually-guided introduction of the first trocar transumbilically without any need for a pursestring suture, with an operative time of about 1 min. The author recommends TUOL as it is easier, less expensive, and less time-consuming compared to other techniques.

Adolescent↗
PubMed1997

The use of tissue expansion for the treatment of burn scar alopecia.

Tissue expansion is an ideal reconstructive procedure for burn scar alopecia. Donor tissue is generated in situ, allowing for the use of hair-bearing tissue to reconstruct an area of alopecia. The process of tissue expansion results in a redistribution of the remaining hair follicles to replace the area of alopecia.

Alopecia↗
PubMed1997

Laparoscopic versus traditional fundoplication in the treatment of children with refractory gastro-oesophageal reflux.

BACKGROUND/AIMS: A retrospective study has been carried out on the last 20 consecutive patients operated for gastro-oesophageal reflux to compare the results of the traditional operation with those using the laparoscopic approach. METHODS: In ten cases, the operation was performed with an open traditional approach and in the other 10 cases using laparoscopy. The mean age of the patients was 7 years and their mean weight was 20 kg. There were 11 girls and 9 boys. We used a 360 degrees Nissen fundoplication in the patients operated on via laparotomy and a Nissen-Rossetti fundoplication in patients operated on via laparoscopy. RESULTS: Mean operating time was 65 minutes for traditional surgery and 100 minutes for laparoscopy. There were two complications: 1 case of oesophageal perforation in a child affected by endo-brachyoesophagus with peri-oesophagitis, operated using the laparoscopic technique, and one case of wound infection in a child operated with the open technique. The hospital stay was remarkably shorter and less painful for the children operated on laparoscopically. At 13-month mean follow-up, all 20 patients are alive and present no reflux symptoms. CONCLUSIONS: Our results demonstrate that laparoscopic surgery is a valid alternative to the traditional surgical approach for the treatment of gastro-oesophageal reflux.

Adolescent↗
PubMed1997

Percutaneous blind needle biopsy versus combined laparoscopic excisional and guided needle biopsy in the diagnosis of liver disorders in pediatric patients.

AIMS: The authors retrospectively analyzed the results of their experience with combined laparoscopic excisional and guided needle biopsy in the determination of chronic liver disease in children. PATIENTS AND METHODS: Between January 1986 and January 1996, at the Division of Pediatric Surgery of the "Federico II" University of Naples, eighty patients underwent laparoscopic liver biopsy to evaluate a chronic liver disease. Patient ages ranged between 50 days and 16 years (mean 5.8 years). There were 41 girls and 39 boys. Fifteen of these children (18.7%) were addressed to a surgeon because the previously performed percutaneous blind needle biopsy was not sufficiently informative or because the specimens were too small to allow chemical or biochemical tissue studies. In these 15 patients, we performed a combination of laparoscopic guided needle biopsy using a 14-gauge tru-cut needle together with an excisional biopsy on the right lobe, using two additional 5-mm trocars. RESULTS AND CONCLUSION: The post-operative course was uneventful for all the patients. All patients were discharged from hospital after 24 hours. A precise histological diagnosis was made and biochemical tissue studies were possible after laparoscopic biopsy in all 15 children. In our opinion, a combination of laparoscopic-guided needle biopsy and laparoscopic excisional biopsy is more reliable than simple biopsy alone for the diagnosis of cirrhosis in children with chronic liver disease.

Adolescent↗
PubMed1996

Transglutaminase from rat coagulating gland secretion. Post-translational modifications and activation by phosphatidic acids.

Structural and biochemical characteristics of transglutaminase purified by a rapid chromatographic procedure from the rat coagulating gland (anterior prostate) secretion are reported. Fast atom bombardment mapping and automated Edman degradation experiments allowed us to verify that at least 85% of the entire transglutaminase amino acid sequence is identical to that derived from the cDNA of the major androgen-dependent rat prostate protein called DP1. The enzyme was found NH2 terminally blocked and largely post-translationally modified, since the presence of N-linked oligosaccharides, as well as of complex lipidic structures, was observed. Mass spectral analysis showed that Asn-408 and -488 are the glycosylated sites, the N-linked structures identified belonging to both high-mannose and complex type glycans. The presence of myo-inositol, of glycerol bound fatty acids, and the high content of mannose residues, are in agreement with previous observations suggesting that a lipid anchor is bound to coagulating gland secretion transglutaminase. Furthermore, two tightly bound calcium ions per molecule of enzyme were detected. Finally, a strong stimulation of the enzyme activity in vitro by both SDS and a variety of phosphatidic acids was observed. The reported structural and functional peculiarities should definitively lead to consider the prostate enzyme as a new member (type IV) of the transglutaminase family.

Amino Acid Sequence↗
PubMed1996

Human microtubule-associated protein 1a (MAP1A) gene: genomic organization, cDNA sequence, and developmental- and tissue-specific expression.

Microtubule-associated proteins (MAPs) regulate microtubule stability and play critical roles in neuronal development and the balance between neuronal plasticity and rigidity. MAP1a (HGMW-approved symbol MAP1A) stabilizes microtubules in postnatal axons. We describe human MAP1a's genomic organization and deduced cDNA and amino acid sequences. MAP1a is a single-copy gene spanning 10.5 kb. MAP1a coding sequence is contained in five exons. Translation begins in exon 3. Human MAP1a contains 2805 amino acids (predicted molecular weight 306.5 kDa) and is slightly larger than rat MAP1a (2774 amino acids). Like rat and bovine MAP1a, human MAP1a contains conserved tubulin binding motifs in the amino-terminal region. The carboxy-terminal portion contains a conserved pentadecapeptide that is present in the light chain portion of rat and bovine MAP1a/LC2 polyprotein. We show that human MAP1a gene expression occurs almost exclusively in the brain and that there is approximately 10-fold greater gene expression in adult brain compared to fetal brain. Strong, interspecies conservation between human and rat MAP1a cDNA and amino acid sequences indicates important relationships between MAP1a's function and its primary amino acid sequence.

Adult↗
PubMed1996

Dissociation of glomerular hypertrophy, cell proliferation, and glomerulosclerosis in mouse strains heterozygous for a mutation (Os) which induces a 50% reduction in nephron number.

We reported that the Os mutation in ROP mice induced a 50% reduction in nephron number, glomerular hypertrophy, and severe glomerulosclerosis. We examined two mouse strains with the Os mutation, ROP Os/+ and C57 Os/+ mice, to determine whether the genetic background influenced the development of glomerulosclerosis. Nephron number was decreased by 50% in both ROP Os/+ and C57 Os/+ mice, and a glomerular volume and labeling index were two- to threefold increased in both. Whereas glomerulosclerosis was severe in ROP Os/+ mice, it was absent or minimal in C57 Os/+ mice. ROP Os/+ glomeruli had two- to threefold more type IV collagen, laminin, and tenascin than C57 Os/+ by immunofluorescence microscopy. Glomerular alpha 1IV collagen and tenascin mRNA levels were increased (2.8- and 1.7-fold) in ROP Os/+ and in C57 Os/+ (1.7- and 1.4-fold) mice. Both ROP Os/+ and C57 Os/+ mice had a slight increase (1.5- and 1.7-fold) in 72-kD collagenase mRNA levels. Whereas laminin B1 mRNA levels were twofold higher in ROP +/+ than in C57 +/+ mice, there was no further change in the presence of the Os mutation. Thus, the response to the Os mutation depended on the mouse strain, since severe glomerulosclerosis occurred only in ROP Os/+ mice, even though cell proliferation and glomerular hypertrophy also were present in C57 Os/+ mice.

Animals↗
PubMed1996

Inhibition of diabetic nephropathy by a GH antagonist: a molecular analysis.

Streptozotocin-treated C57B1/SJL mice developed glomerular hypertrophy and light microscopic lesions mimicking human diabetic glomerulosclerosis. In contrast, there were no glomerular hypertrophy and lesions in diabetic mice transgenic (TG) for a mutated growth hormone (bGH-G119K) that competes with native endogenous GH and results in dwarfism. We examined the molecular events underlying these findings. The non-transgenic (non-TG) diabetic mouse glomeruli had an increase in mRNA coding for alpha 1IV collagen, laminin B1, TGF-beta 1, 72 kDa collagenase, and TIMP-3. In contrast, glomerular type IV collagen and laminin B1 mRNA levels were normal in diabetic TG dwarf mice. However, the 72 kDa gelatinase, TIMP-3, and TGF-beta 1 mRNAs were elevated in the diabetic dwarfs. Type IV collagen and laminin accumulated in the glomeruli of diabetic non-TG, but not of diabetic dwarf mice, by immunofluorescence microscopy, confirming the mRNA data. GH binding protein mRNA levels were comparable in glomeruli from dwarf and non-TG mice, both diabetic and non-diabetic. We did not detect GH receptor mRNA in glomeruli. These data suggest that diabetic glomerulosclerosis is associated with an increase in type IV collagen and laminin synthesis, and that these changes do not occur in mice transgenic for bGH119K, a functional antagonist of GH. The increase of 72 kDa gelatinase, TIMP-3 and TGF-beta 1 mRNAs, independent of GH, suggested that these changes induced by hyperglycemia were not sufficient for the induction of glomerulosclerosis.

Animals↗