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C Pesce

Publications and source records attributed to C Pesce.

At least 37 records · Page 2Linked to original sources
PubMed1998

Glomerular number and size: facts and artefacts.

This review article is concerned with clinical and experimental data on glomerular number and size and includes a critical discussion of the relevant stereological methods. There is considerable evidence supporting the view that the size of the glomerular filter, in toto, is related to the inception and development of glomerular disease. Major divergences from the filter size are incompatible with normal structure and function. Furthermore, the hypothesis has been put forward that there exists a subset of individuals with minor divergences from the norm that is more susceptible to glomerular disease than the general population. Stereological methods for estimating glomerular number and mean glomerular size could be applied to set standard values. In addition, if the above hypothesis is confirmed, then they could identify on biopsy specimens the patients that belong to cohorts at risk of developing glomerular disease. Unfortunately, despite the development of new, robust methods for particle counting and size determination, such as the fractionator and the dissector, no universal standards of glomerular number and size have been agreed on to date. The major difficulties depend on 1) establishing a standard protocol of tissue acquisition and processing and 2) defining possible variations across age, sex, and ethnic subgroups. The considerable effort required to overcome these difficulties should be rewarded, however, by important advances in the understanding of the morphogenesis of glomerular disease and in the diagnostic and prognostic yield of renal biopsy.

Animals↗
PubMed1998

Endoscopic and minimal open surgical incision of ureteroceles.

Ureterocele decompression by endoscopic or open incision was the primary treatment in 59 children with 63 ureteroceles. Of these, 18 were intravesical and 45 were ectopic. The endoscopic or open incision adequately decompressed all intravesical ureteroceles and 37 of 45 ectopic ureteroceles (82%). After incision, the secondary operation rate was 17% for intravesical and 62% for ectopic ureteroceles. In our opinion, endoscopic or open incision must be considered a definitive treatment in the large majority of intravesical ureteroceles and is also valid in ectopic ureteroceles. In these cases, the early decompression obtained by this approach produced significant functional recovery, fewer urinary tract infections, and facilitated subsequent surgery in those patients requiring complete surgical reconstruction.

Child↗
PubMed1998

Acrokeratoelastoidosis of Costa: a primary disease of the elastic tissue?

A 24-year-old black woman from Uganda was seen for treatment of multiple papules on her hands and feet. The lesions corresponded microscopically to foci of hyperkeratosis and acanthosis. Acid orcein stain revealed marked elastic fiber fragmentation. Acrokeratoelastoidosis of Costa (AKE) was diagnosed. The same damage to the elastic fibers was also present in an additional specimen from grossly uninvolved skin. On electron microscopy there were pronounced changes of the elastic fibers with elastolysis in both specimens. This case with generalized damage of the dermal elastic tissue supports the view that elastorrhexis is the key feature of AKE. Accordingly, the disease could be regarded as a primary elastic tissue disorder. The marginal acral keratoderma that is seen in AKE patients could represent epidermal changes secondary to chronic trauma.

Adult↗
PubMed1997

G-cell density in the antral mucosa: a feasibility study.

In this work a new method for gastrin-secreting cell (G-cell) density measurement was employed in order to test the hypothesis that G-cell density of the antral mucosa can be estimated with an acceptable degree of error. The zone of antral mucosa where most G-cells are located was demarcated, its area was measured and the G-cells within this area were counted. The variation in the e error of the estimate according to normal distribution theory, and the size of the sampling expected to yield G-cell density values with a given error were assessed. Our data indicate that a very large surface of the G-cell zone should be explored in order to estimate G-cell density with an acceptable degree of error. G-cell density measurement appears not to be feasible on biopsy specimens or, for routine diagnosis, on gastrectomy specimens.

Aged↗
PubMed1997

Early, but not advanced, glomerulopathy is reversed by pancreatic islet transplants in experimental diabetic rats: correlation with glomerular extracellular matrix mRNA levels.

In this study, we investigated 1) whether long-term restoration of euglycemia by means of pancreatic islet transplants is capable of preventing and/or reversing renal functional and structural alterations in an experimental model of insulin-deficient diabetes, and 2) whether changes in extracellular matrix (ECM) and cell turnover at the glomerular level and biochemical abnormalities associated with hyperglycemia correlate with the renal outcome after transplantation. Male Lewis rats, rendered diabetic by intravenous injection of streptozotocin, underwent homologous islet transplantation via the portal vein at 2 weeks (study A), at 4 months (study B), and at 8 months (study C) after the induction of diabetes and killed 12 months after transplantation in study A and 4 months after transplantation in studies B and C. Age-matched nondiabetic and untreated diabetic rats were used as control animals and were studied at 4, 8, and 12 months. In the untreated diabetic animals, metabolic derangement was associated with increased erythrocyte polyol and fructose levels, tail-tendon content of advanced glycation end products (AGEs), total proteinuria, albuminuria, kidney weight, and mean glomerular volume as well as with marked glomerular and extraglomerular lesions. Glomerular gene expression for the ECM components fibronectin and collagen IV and for TGF-beta was also increased, whereas glomerular cell proliferation was unaffected by diabetes. In study A, changes in renal function and structure observed in diabetic rats at 12 months were completely prevented by successful islet transplants. In study B, all functional and structural abnormalities detected in diabetic rats at 4 months of disease duration were virtually reversed by 4 months of euglycemia in transplanted animals, whereas they progressed further in untreated diabetic rats. In study C, the course of functional and structural changes observed in untreated diabetic rats was not reversed by islet transplantation. Likewise, tissue AGE accumulation and particularly upregulation of glomerular ECM and transforming growth factor (TGF)-beta gene expression, which are believed to play a role in the pathogenesis of altered renal function and structure in diabetes, were normalized in transplanted rats from study A and study B, but not in those from study C. These experiments show that restoration of euglycemia by islet transplants is capable of preventing experimental diabetic glomerulopathy and reversing early changes in renal function and structure induced by diabetes. In a later phase of the disease, when glomerular matrix gene expression becomes independent of hyperglycemia, possibly because of the persistent increase in tissue AGE accumulation, metabolic control is not capable of reversing renal abnormalities.

Animals↗
PubMed1996

Temporal changes in insulin-like growth factor I, c-fos, and c-jun gene expression during hyperplastic kidney growth in weanling rats.

We have previously determined that compensatory renal growth (CRG) during the initial 24-48 h after uninephrectomy (UNX) is GH independent in weanling animals, but associated with significant increases in insulin-like growth factor I (IGF-I) and IGF-I receptor gene expression. The purpose of the present study was to determine the temporal sequence of molecular and cellular events that occur at various time points (1, 6, 12, 18, 24, 48, and 72 h post-UNX) during this early period of accelerated renal growth in the weanling (21- to 25-day-old) rat. Rapid and sustained increases in steady state renal IGF-I receptor and IGF-I messenger RNA (mRNA) were observed at 1 and 6 h, respectively, and remained elevated in the remnant kidneys until 72 h post-UNX. The mRNAs for the early response genes, c-fos and c-jun, were not induced in the remnant kidneys from weanling rats until between 12-18 h, but were also sustained through 48 h post-UNX. Increases in remnant kidney DNA content and [3H]thymidine incorporation also occurred from 18-48 h post-UNX and returned to baseline levels by 72 h post-UNX, indicating that the hyperplastic response in the weanling remnant kidney occurs over a discrete period early after UNX. Neither IGF-I nor early response genes were elevated in kidneys from adult animals, which exhibited only hypertrophic renal growth at those early time points after UNX. These findings suggest that early CRG in the weanling rat is associated with rapid increases in IGF-I mRNA followed by a rise in c-fos and c-jun gene expression and a mitogenic response. Furthermore, when the mRNA levels of IGF-I and early response genes returned to baseline levels, mitogenic growth stopped, and slower prolonged hypertrophic renal growth ensued.

Animals↗
PubMed1996

Cauda equina metastasis from ovarian malignancy.

SUMMARY: A case of cauda equina metastasis from ovarian serous papillary adenocarcinoma in a 51-year-old patient is reported. The clinical significance and different hypotheses on the metastatic route to the spine are discussed.

Cauda Equina↗
PubMed1995

Short report: erythema nodosum leprosum lymphadenitis.

A case of isolated erythema nodosum lymphadenitis involving the paravertebral, intercostal, and cervical lymph nodes without concomitant skin involvement is reported in a 62-year-old male patient under treatment for lepromatous leprosy.

Erythema Nodosum↗
PubMed1993

Physiologic effects of positive end-expiratory pressure in patients with chronic obstructive pulmonary disease during acute ventilatory failure and controlled mechanical ventilation.

Dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEPi) are observed in patients with chronic obstructive pulmonary disease (COPD) and flow limitation. Several reports suggest that PEEP levels approaching PEEPi reduce inspiratory load due to PEEPi, without further hyperinflation. Hence PEEP should not increase intrathoracic pressure or affect hemodynamics and gas exchange. To verify this hypothesis, the effects of PEEP (0 to 15 cm H2O) on respiratory mechanics, hemodynamics, and gas exchange were studied in nine COPD patients during controlled mechanical ventilation. PEEP levels approaching PEEPi (9.8 +/- 0.5 cm H2O) did not affect the expiratory flow/volume relationship, confirming the presence of flow limitation. PEEP levels of 5 and 10 cm H2O did not change lung volume and PEEPi in the respiratory system (PEEPtot,rs) and chest wall (PEEPtot,cw) or affect hemodynamics and gas exchange. When applied PEEP overcame PEEPi, changes in lung volume and the expiratory flow/volume relationship were observed. PEEPtot,rs and PEEPtot,cw also increased. Under these circumstances, PEEP increased static elastance in both the respiratory system and the chest wall, reducing cardiac index and affecting hemodynamics and gas exchange. Our data show that in mechanically ventilated COPD patients with PEEPi due to flow limitation, PEEP levels exceeding the 85% of PEEPi (Pcrit) caused further hyperinflation and compromised hemodynamics and gas exchange.

Aged↗
PubMed1993

Glomerulosclerosis and body growth are mediated by different portions of bovine growth hormone. Studies in transgenic mice.

BACKGROUND: Mice transgenic for bovine growth hormone (bGH) gene have increased body weight and severe glomerulosclerosis leading to death in uremia. EXPERIMENTAL DESIGN: The aim of this study was to determine if body growth and glomerulosclerosis were mediated by different bGH regions. Amino acid substitutions in the bGH alpha-helix III were generated, and lines of transgenic mice that expressed these products were developed. Female transgenic mice carrying the native bGH gene (bGH mice), a mutated bGH gene that encodes a destabilized alpha-helix III (bGH-L121P, E126G; bGH-m11 mice), or a mutated bGH gene that encodes a perfect amphiphilic alpha-helix III (bGH-E117L, G119R, A122D; bGH-m8 mice) were examined at 2-3 months and 6-9 months of age. Body, kidney, and heart weights were measured. Urinary glucose, albumin, creatinine, and serum glucose were measured in all mice. Serum levels of insulin-like growth factor I (IGF-I) were measured in the 2-3 month group. Whole blood hemoglobin A1 was measured in some mice of the 6-9 month group. Kidney sections were examined by light and immunofluorescence microscopy. Glomerular volume was measured and related to body weight by allometry. RESULTS: The bGH-m11 mice developed glomerulosclerosis indistinguishable from that seen in bGH transgenic mice, even though they had normal body size. Glomerular growth exceeded body growth by allometry in both bGH and bGH-m11 strains. bGH-m8 mice had glomeruli of appropriate size and normal histologic appearance; however, they were dwarfs. IGF-I was increased in bGH mice; they also had an increased albumin/creatinine ratio at 6-9 months. None of the mice were hyperglycemic. CONCLUSIONS: These data indicated that development of glomerulosclerosis and body growth promotion were mediated by different regions of the growth hormone molecule. The glomerular response to bGH was unique and consisted of increased size and glomerulosclerosis.

Animals↗
PubMed1992

A quantitative approach to the classification of hypospermatogenesis in testicular biopsies for infertility.

Absolute counts of germ cells were performed in 110 testicular biopsy specimens from 59 patients with either idiopathic infertility or varicocele and in a series of five autopsy specimens from age-matched controls. The tubular diameter, thickness of the tubular wall, and density of Leydig cells were measured. The following patterns were identified by germ-cell counts in the biopsy specimens: normal cell population, mild decrease in germ cells with normal ratio of cell types, advanced hypospermatogenesis with abnormal ratio of cell types, and Sertoli cell only. This sequence of progressive hypospermatogenesis was remarkably similar in both series. A separate category of maturation arrest was not recognized. Cell counts also correlated between right- and left-sided samples from the same patient in both series of biopsies. Reduction of tubular diameter, thickening of the tubular wall, and increase in Leydig cell density were often seen in severe stages of germ-cell impairment, although with an irregular distribution.

Adult↗
PubMed1992

Large glomerular size in Pima Indians: lack of change with diabetic nephropathy.

The mean glomerular volume, glomerular fraction of cortical volume, and percentage of obsolescent glomeruli were calculated in kidney specimens from autopsies on 34 Pima Indians, of whom 15 had non-insulin dependent diabetes mellitus and kidney disease of diabetes mellitus. These values were compared with those of black, white, and non-Pima native American individuals without diabetes mellitus. Glomerular volume in the Pima Indians was similar in the diabetic and nondiabetic subjects and significantly greater than in the white subjects. Black and non-Pima native American individuals had glomerular volumes intermediate between white individuals and Pima Indians. The mean glomerular volume was not affected by the number of obsolescent glomeruli in diabetic Pima Indians. The glomerular volume fraction was greater in the Pimas than in the other groups. These data showed that glomerular volume in the Pima Indians was significantly greater than that in white subjects. There was no difference between diabetic and nondiabetics Pimas, and glomerular size was not correlated with the presence or degree of glomerulosclerosis in this population.

Adolescent↗
PubMed1992

[Multicenter study on the treatment and outcome of patients admitted to intensive care units in Italy. Presentation of the research project and the study protocol. GiViTI (Gruppo Italiano per la Valutazione degli interventi in Terapia Intensiva)].

Although Intensive Care Units (ICU) are present in most of the Italian Hospitals for acute patients, the heterogeneity of the patients case-mix and the large variation in structural, organizational and staffing arrangements have limited the feasibility and precision of evaluation studies aimed at assessing the quality of health care delivered and its impact on patients outcomes. To our knowledge there has been no nationwide study aimed at assessing the quality and effectiveness of the delivered care in samples of ICUs and patients that are representative of the source populations. To study the effects of variations in health care practices on the outcome of the patients admitted in ICU, we designed a multicentric observational study involving 120 ICUs within the country. The present study is the first part of a project involving a network of Intensive Care Units gathered under the name of GiViTI-Italian Group for the Evaluation of the Interventions in Intensive Care-that is representative of the national Italian reality in the field. The idea of a large collaborative group acting in the field of Intensive Care stands in line with several quality, effectiveness and resource utilization studies that are ongoing in other European countries and is also the result of a series of smaller-scale experiences carried out by other Italian groups eventually emboied in the GiViTI project. In the framework of the ongoing long term, multisite, and multidisciplinary project, the present study calls for the recruitment of all consecutive patients seen at the participant centers during a two months period.(ABSTRACT TRUNCATED AT 250 WORDS)

Critical Care↗
PubMed1991

Endometrial carcinoma with trophoblastic differentiation. An aggressive form of uterine cancer.

Three cases of poorly differentiated endometrial adenocarcinoma showing trophoblast-like differentiation are reported. The multinucleated, syncytiotrophoblast-like cells were strongly positive for beta-human chorionic gonadotropin (beta-HCG) by immunohistochemical study. High levels of beta-HCG were also present in the patients' serum, but dropped significantly after treatment. The patients had an unusually rapid and progressive clinical course with widespread dissemination and death by tumor.

Adenocarcinoma↗