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Biomedical subjects

C Pesce

Publications and source records attributed to C Pesce.

At least 19 recordsLinked to original sources
PubMed2003

Coexisting pelviureteral and vesicoureteral junction obstruction in children.

OBJECTIVE: To address reasons for diagnostic failure in children with coexisting pelviureteral and vesicoureteral junction obstruction. PATIENTS AND METHODS: A total of 11 children with coexisting pelviureteral and vesicoureteral junction obstruction are reported. This anomaly was recognised at presentation in only 5 (45%) of cases. In the remainder, correct diagnosis was made after initial pyeloplasty and a significant delay occurred in 3 children. In all 11 patients treatment consisted of pyeloplasty and subsequent reimplantation. RESULTS: A satisfactory postoperative course with improvement of urinary tract dilatation was noted in all 11 patients, while 8 of 11 patients showed preserved renal function at late follow-up. CONCLUSION: According to the few available data, our data confirm the difficulty of diagnosing coexisting pelviureteral and vesicoureteral junction obstruction in children. However, prompt recognition and relief of urinary obstruction in these patients is mandatory in order to prevent deterioration of renal function.

Dilatation, Pathologic↗
PubMed2001

Inhibition of angiogenesis-driven Kaposi's sarcoma tumor growth in nude mice by oral N-acetylcysteine.

The thiol N-acetyl-L-cysteine (NAC), an analogue and precursor of reduced glutathione, has cancer chemopreventive properties attributable to its nucleophilicity, antioxidant activity, and a variety of other mechanisms. We demonstrated recently that NAC has anti-invasive, antimetastatic, and antiangiogenic effects in in vitro and in vivo test systems. In the present study, s.c. transplantation of KS-Imm cells in (CD-1)BR nude mice resulted in the local growth of Kaposi's sarcoma, a highly vascularized human tumor. The daily administration of NAC with drinking water, initiated after the tumor mass had become established and detectable, produced a sharp inhibition of tumor growth, with regression of tumors in half of the treated mice along with a markedly prolonged median survival time. The production of vascular endothelial growth factor (VEGF) and certain proliferation markers (proliferating cell nuclear antigen and Ki-67) were significantly lower in Kaposi's sarcomas from NAC-treated mice than from control mice. Treatment of KS-Imm cells with NAC in vitro resulted in a dose-dependent inhibition of chemotaxis and invasion through inhibition of gelatinase-A (matrix metalloproteinase-2, MMP-2) activity without altering MMP-2 or MMP-9 mRNA levels. NAC also significantly inhibited VEGF production but did not affect proliferation markers in vitro. Reverse transcription-PCR analysis indicated that total VEGF mRNAs were reduced by 10 mM NAC. Taken together, these findings provide evidence that NAC, the safety of which even at high doses has been established in almost 40 years of clinical use, in addition to its chemopreventive action, has a strong antiangiogenic potential that could be exploited for preventing cancer progression as well as used in cancer adjuvant therapy.

Acetylcysteine↗
PubMed2001

Reoperative orchiopexy: surgical aspects and functional outcome.

Over a 14-year period, a total of 40 patients underwent surgical revision after an unsuccessful orchiopexy attempt. Overall, 34 reorchiopexies (1 bilateral) and 7 orchiectomies were performed. All reorchiopexies were carried out using extensive mobilization of the testis and spermatic cord. This approach was sufficient for scrotal placement of the testis in 23 instances; however, it was necessary to transpose the spermatic vessels medially in the remaining 11 (incision of the transversalis fascia in 5, incision of the transversalis fascia and division of the inferior epigastric vessels in 6). Only 1 prepuberal boy developed testicular atrophy (2%). Functional long-term assessment was done in 20 postpuberal patients using testicular ultrasound and sperm analysis. The reoperated cryptorchid testes were significantly smaller than the controls (P < 0.005), but decreased fertility was only noted in 3 patients (18.7%). We conclude that testicular volume in adulthood is not directly related to fertility, so that accurate reorchiopexy seems to be the best way to preserve fertility in this special group of cryptorchid patients.

Child↗
PubMed2001

Successful use of transureteroureterostomy in children: a clinical study.

The purpose of this review of patients was to look at the current role of transureteroureterostomy in children. In addition, this study should give an indication of the long-term safety of transureteroureterostomy in children with neurogenic bladder. From 1972 on, 70 subjects between the ages of 2 and 13 underwent transureteroureterostomy. In 68 patients (97 %), transureteroureterostomy was used as a salvage renal procedure after unsuccessful ureteroneocytostomy attempts at other institutions. In 2 patients (3 %), transureteroureterostomy was used as a diversion procedure. The postoperative course was uneventful except for 1 case of early anastomotic occlusion successfully treated by application of a double-J stent. No patient required surgical revision of the ureteral anastomosis. However, 4 patients with neurogenic bladder from myelomeningocele developed sequelae. Of these, 1 presented with stenosis at the end of the recipient ureter, 2 had occurrence of vesicoureteral reflux in nonreimplanted recipient ureter, 1 developed calculi in the donor pelvis. This study supports the view that transureteroureterostomy is highly useful for the management of children with a wide spectrum of urological anomalies. However, long-term monitoring of patients with neurogenic bladder who have undergone this procedure is essential to achieve a long-term good outcome.

Adolescent↗
PubMed2000

A video densitometric analysis of viral burden and follicular dendritic cell damage in lymph nodes in the latency phase of HIV infection.

BACKGROUND: The aim of this study was to collect quantitative data on damage to follicular dendritic cells (FDC) and on the structure of germinal centers (GC) in the early phase of HIV infection. METHODS: Lymph node sections from 10 HIV(+) subjects and from 5 HIV(-) control subjects were stained by immunohistochemistry for CD21, an FDC marker; gp24, to assess the HIV load; and IgM, to measure antibodies within the GC. RESULTS: The volume fraction (V(area)) and the logarithm of the inverse gray value (ArLIGV) of CD21 areas showed a highly significant decrease in HIV(+) specimens. The mean ArLIGV values ranged between 0.0916 +/- 0.01 and 0.3826 +/- 0.11 versus 0.6856 +/- 0.19 on average in controls (P < 0.001 for both). Six of 10 HIV(+) specimens were positive for gp24. Staining was limited to GC and showed a distribution pattern similar to that of CD21. CONCLUSIONS: FDC already undergo considerable damage during the latency phase of HIV infection. The pattern of CD21 indicates that, although FDC decrease in number, the staining intensity of positive cells is basically preserved. Video densitometric analysis, an approach requiring a strict standardized protocol, may help monitor disease course and evaluate response to therapy by quantifying viral burden and lymph node damage.

Dendritic Cells, Follicular↗
PubMed2000

Induction of alopecia in mice exposed to cigarette smoke.

Besides being responsible for a high proportion of those chronic degenerative diseases that are the leading causes of death in the population, tobacco smoking has been associated with skin diseases. Smoke genotoxicants are metabolized in hair follicle cells, where they form DNA adducts and cause DNA damage. The suspicion was raised that, in humans, a link may exist between smoking and both premature grey hair and hair loss. In order to check this hypothesis, we carried out a study in C57BL/6 mice exposed whole-body to a mixture of sidestream and mainstream cigarette smoke. After 3 months exposure, most mice developed areas of alopecia and grey hair, while no such lesions occurred either in sham-exposed mice or in smoke-exposed mice receiving the chemopreventive agent N-acetylcysteine with drinking water. Cell apoptosis occurred massively in the hair bulbs at the edge of alopecia areas. Smoke-exposed mice had extensive atrophy of the epidermis, reduced thickness of the subcutaneous tissue, and scarcity of hair follicles. On the whole, exposure to smoke genotoxic components appears to alter the hair cycle with a dystrophic anagen pattern. Although this mechanism is different from that of genotoxic cytostatic drugs, N-acetylcysteine appears to exert protective effects in both conditions.

Acetylcysteine↗
PubMed2000

Apoptosis in the areas of squamous differentiation of irritated seborrheic keratosis.

Seborrheic keratosis (SK) consists of a localized proliferation of basaloid keratinocytes, often accompanied by hyperkeratosis and hyperpigmentation. In irritated SK, these features are associated with areas of squamous differentiation with larger keratinocytes and squamous cell eddies. This work is concerned with the evaluation of apoptosis, as demonstrated by the TUNEL method, in the different varieties of SK. Apoptosis was highly expressed in the areas of squamous differentiation of irritated SK, but only mildly increased in the other varieties of SK. These data support the hypothesis that apoptosis has a role in the squamous differentiation of irritated SK. In consideration also of previous data showing that irritated SK is associated with downregulation of EGF-R expression and 125I-EGF binding, we postulate that the morphologic features of irritated SK could correspond to an involution phase of the disease, characterized by altered cell balance with inadequate cell renewal and increased cell loss.

Adult↗
PubMed2000

Relevance of infection in children with urachal cysts.

OBJECTIVE: To assess the role of infection in the management of children with urachal cysts. METHODS: A retrospective study on 10 children with urachal cysts operated on over an 11-year period (from 1987 to 1998) was performed. Uncomplicated urachal cysts were found in 2 children who underwent primary cyst removal. The remaining 8 were admitted with severe sepsis due to the presence of a urachal abscess; they were managed by a staged approach including percutaneous drainage and delayed cyst removal. The diagnosis of urachal cyst was readily made by ultrasound in all the 10 patients (100%). In 1 patient with urachal abscess, computed tomography provided additional information. RESULTS: The postoperative course was uneventful in 9 of 10 children (90%). A 5-year-old female patient developed peritonitis following urachal abscess rupture into the peritoneal cavity, which resulted in additional surgery and prolonged hospitalization. CONCLUSIONS: (1) Ultrasound is an excellent diagnostic tool for patients with urachal cysts. (2) A renal screening ultrasound must be included in the preoperative work-up. (3) A thorough urological assessment is indicated in patients with abnormal renal ultrasound of recurrent urinary infections. (4) At present, a staged surgical procedure still remains the most effective surgical option in children with urachal cyst.

Abscess↗
PubMed2000

Early hyperplastic renal growth after uninephrectomy in adult female rats.

The early, accelerated remnant kidney growth following uninephrectomy (UNX) occurs through alternate mechanisms in juvenile and adult male rats, which may govern the type of renal growth that occurs after UNX. Early compensatory renal growth (CRG) in the adult male rat is GH dependent, but independent of changes in the renal insulin-like growth factor I (IGF-I) system. In contrast, CRG is GH independent in the juvenile male rat, but is associated with significant increases in the renal IGF-I system, and hyperplastic kidney growth. The few studies that examined early CRG in female animals suggest that remnant kidney growth is less than that observed in males, and there is a hyperplastic component, indicating potential gender differences. Whether these differences result from alternate growth mechanisms is unknown. The purpose ofthe present study was to determine the rate, type, and potential mechanism of early remnant kidney growth in adult female rats after UNX. GH levels were determined in conscious, sham-operated, and UNX adult female Wistar rats 24 h postsurgery. Unlike previous findings in adult male UNX rats, pulsatile GH levels were not elevated in UNX female rats. When GH release was suppressed using an antagonist to GH-releasing factor, remnant kidney growth was not different from that in saline/UNX remnant kidneys (25.7+/-4.8% vs. 27.7+/-2.1%, respectively, at 48 h post-UNX). This GH-independent CRG was associated with significant hyperplastic growth in both adult andjuvenile female remnant kidneys, as determined by bromodeoxyuridine incorporation and increases in total DNA. Also associated with the mitogenic growth in the adult female were significant 2- to 4-fold increases in remnant kidney IGF-I receptor gene expression, which occurred in the presence and absence of pulsatile GH secretion. Lastly, the growth rate of adult female remnant kidneys was not different from that observed in male remnant kidneys at these early time points (0.21+/-0.02 vs. 0.20+/-0.02 g at 24 h, and 0.26+/-0.02 vs. 0.30+/-0.03 g at 48 h in female and male remnant kidneys, respectively; P = NS). Thus, in female rats, the initial phase of CRG is GH independent, but is associated with significant increases in remnant kidney IGF-I receptor gene expression and hyperplastic renal growth. This, in addition to previous findings, indicates that there are sex differences in early CRG after UNX. Moreover, the findings confirm that the mechanism governing the initial phase of CRG appears to be a critical determinant for significant hyperplastic remnant kidney growth.

Aging↗
PubMed1999

Focal malakoplakia in chronic periapical periodontitis.

AIMS: Three cases of chronic periapical periodontitis including focal areas with malakoplakia changes are reported. METHODS AND RESULTS: These areas included both von Hansemann-type macrophages and periodic acid-Schiff-positive, iron- and calcium-containing concretions. Some concretions corresponded to spherules with a targetoid configuration, thus fitting the morphological criteria for classical Michaelis-Gutmann bodies. CONCLUSION: The vast majority of the cases of malakoplakia that have been reported in the literature corresponded to a characteristic, fairly homogeneous lesion, but a few instances of focal malakoplakia have been described in various chronic conditions. These considerations support the opinion that the local conditions for the production of Michaelis-Gutmann bodies may occur focally in diseases characterized by macrophage accumulation.

Adult↗
PubMed1999

Gender differences in renal growth and function after uninephrectomy in adult rats.

BACKGROUND: It is known that compensatory renal growth (CRG) following unilateral nephrectomy (UNX) increases both the size of the kidney and its functional capacity; however, few studies have investigated whether differences in CRG exist between the sexes. Our study examined the sex-related differences in remnant kidney growth and function two months following UNX. METHODS: Adult male and female Wistar rats underwent either left UNX or sham operation and recovered for 8 to 10 weeks. Another group of female rats underwent ovariectomy (Ox), with vehicle, estrogen, or testosterone replacement: two-weeks postsurgery animals underwent UNX and recovered for 8 to 10 weeks. Metabolic studies, acute renal function studies [response to acute saline volume expansion (2 to 4% of body wt) or phosphate (Pi) infusions in thyroparathyroidectomized rats (to determine the transport maximum (TmPi)], and renal morphology were assessed at the end of the experimental period. RESULTS: Two months post-UNX, male remnant kidneys grew 114+/-7% of their excised kidney weight (KW), whereas female remnant kidneys grew only 57+/-4% (P<0.05). There was a significant increase in the glomerular volume of male remnant kidneys (126.2+/-13.4%, P<0.001) compared with control kidney volume, whereas there was no change in glomerular volume in female remnant kidneys (20.2+/-16.1%, P = NS). There was also glomerular and tubular damage in the male remnant kidneys, whereas female remnant kidneys were intact. Studies in Ox female rats supplemented with gonadal steroids determined that testosterone is the driving force for the enhanced remnant kidney growth and glomerular hypertrophy. Renal function studies determined that UNX males had significantly higher glomerular filtration rates (GFRs) than UNX females, although the GFR/single KW was not different between the sexes, indicating a proportional increase in GFR. Basal urinary sodium excretion and urine flow rates were significantly higher in anesthetized UNX rats than their sham-operated controls, and urinary sodium excretion and urine flow rates in UNX males were significantly higher than in UNX females. Both male and female UNX rats responded to volume expansion with an exaggerated initial sodium and urine excretion compared with their controls. Phosphate handling was not altered in UNX male rats; however, UNX female rats had increases in fractional Pi excretion that were associated with significant reductions in the maximum capacity for Pi reabsorption (2.10+/-0.07 vs. 3.43+/-0.24 micromol/ml GFR in female controls, P<0.0001). This difference was also observed in Ox rats treated with estrogen and testosterone (2.31+/-0.07 vs. 3.12+/-0.11 micromol/ml GFR, P<0.0007). CONCLUSIONS: These findings indicate that sexual dimorphism exists in remnant kidney growth and function two months following UNX. Indeed, morphological abnormalities and impairment in renal phosphate handling are affected by gonadal steroids by two-months post-UNX. The fact that renal Pi transport was reduced in female but not male UNX rats may also have important implications during periods of high metabolic demand for phosphate in the female.

Animals↗
PubMed1999

Fatal cardiac tamponade as a late complication of central venous catheterization: a case report.

Central venous catheterization is a reliable technique in neonatal surgery. Nevertheless, the rate of mechanical catheter-related complications remains high. We report a neonate with gastroschisis in which the successful placement of a central venous catheter was followed later by a cardiac tamponade with a fatal outcome. This complication occurred without perforation of the cardiac wall. A similar finding has been reported in only one other pediatric patient. Vigilant observation is required in any neonate with a central venous line in place to prevent the occurrence of this life-threatening event.

Cardiac Tamponade↗
PubMed1999

Ureterovascular hydronephrosis in children: is pyeloplasty always necessary?

OBJECTIVE: To evaluate the efficacy of the vessel transposition technique in ureterovascular hydronephrosis in children. METHODS: Over a 25-year period, we treated 111 patients with 112 instances of ureterovascular hydronephrosis. In order to determine the obstructive effect of the vessels, we performed an intraoperative diuretic test. Using this approach, 61 patients judged to have only vascular pyeloureteral junction obstruction underwent vessel transposition. However, 50 patients in whom the intraoperative diuretic test proved doubtful needed pyeloplasty. RESULTS: Surgical success was achieved in 98% of the patients. Only 1 child treated by vessel transposition had an unsatisfactory outcome which necessitated a subsequent pyeloplasty for persistent hydronephrosis. This was due to a previously unrecognized intrinsic pyeloureteral junction obstruction. CONCLUSION: Based on our clinical experience, the intraoperative diuretic test has proven to be a safe and effective diagnostic tool in children with ureterovascular hydronephrosis. Its use may contribute to treating some cases of ureterovascular hydronephrosis without resorting to pyeloplasty.

Adolescent↗
PubMed1999

Cell counting and three-dimensional reconstruction to identify a cellular wave in human spermatogenesis.

OBJECTIVE: To collect quantitative and stereologic data on the main cell types represented in the seminiferous tubule in order to produce a three-dimensional representation of the morphologic events of normal cell production and maturation. STUDY DESIGN: Three-dimensional reconstruction and differential cell counting were performed on serial sections of normal testicular tissue from normal young men through image analysis and computer-based rendering. RESULTS: Peculiar periodicity in the total number of tubular cells considered along the sequence of serial sections was recognized. Also, consensual periodicity pertaining to each cell type was recognized. Adjacent high cellularity and low cellularity segments included a fairly constant mixture of cell types considered. CONCLUSION: A newly defined cellular wave, composed of regular alternations of high and low cellularity segments, was identified in the normal human seminiferous tubule.

Adult↗