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Biomedical subjects

Christopher P Coppola

Publications and source records attributed to Christopher P Coppola.

5 recordsLinked to original sources

Children treated at an expeditionary military hospital in Iraq.

OBJECTIVE: To describe the treatment of children at an expeditionary military hospital in wartime Iraq. DESIGN: Descriptive, retrospective study. SETTING: The 332nd Air Force Theater Hospital in Balad, Iraq, January 1, 2004, to May 31, 2005. PATIENTS: All 85 children (of 1626 total patients) evaluated and treated at the hospital during the study period. INTERVENTIONS: Indicated surgical procedures performed on children. MAIN OUTCOME MEASURES: Age, sex, diagnosis, injury, operations, and complications for children during the study period. RESULTS: The 85 children (age range, 1 day to 17 years; mean, 8 years) represented 5.2% of all patients. Thirty-four (61%) of the 56 children for whom sex was recorded were male. Injury was the diagnosis for 48 children (56%). Of these, the cause was fragmentation wound in 25 children (52%), penetrating trauma in 11 (23%), burn in 9 (19%), and blunt trauma in 3 (6%). The site of injury was the lower extremity in 18 children (38%), head in 11 (23%), upper extremity in 8 (17%), abdomen in 8 (17%), and chest in 3 (6%). Nontraumatic conditions had congenital, infectious, gastrointestinal, and neoplastic causes. During the study, 134 operations were performed on 63 children. There were 5 deaths. CONCLUSIONS: Expeditionary military hospitals will encounter both injured and noninjured children seeking medical care. To optimize the care of these children, it will be necessary to provide the proper personnel, training, and equipment.

Adolescent↗

Prophylactic bilateral salpingo-oopherectomy in a 17-year-old with Frasier syndrome reveals gonadoblastoma and seminoma: a case report.

Mutations in the Wilms' tumor gene are present in children with Frasier syndrome, Denys-Drash syndrome, WAGR syndrome, and some cases of Wilms' tumor. The Wilms' tumor gene product, WT1, is necessary for normal urogenital development. Frasier syndrome is an association between focal segmental glomerulosclerosis, beginning in the second and third decade, male to female sex reversal, and dysgenetic gonads. We report a case of Frasier syndrome in a 17-year-old adolescent girl with renal failure, kidney transplant, and dysgenetic gonads, with development of gonadoblastoma and dysgerminoma (seminoma). The diagnosis of Frasier syndrome was based on nephrotic syndrome with diffuse mesangial sclerosis leading to chronic renal failure, dysgenetic gonads, 46 XY karyotype in a phenotypic female, and a mutation in the Wilms' tumor gene. Prophylactic laparoscopic bilateral salpingo-oopherectomy revealed gonadoblastoma and seminoma in opposite atrophic ovaries as well as a hypoplastic uterus. Early prophylactic resection of dysgenetic gonads is indicated in children with Frasier syndrome to prevent the development of germ cell malignancy.

Adolescent↗

Nitrovasodilator responses in pulmonary arterioles from rats with nitrofen-induced congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Many infants with congenital diaphragmatic hernias (CDHs) experience persistent pulmonary hypertension that is refractory to treatment with inhaled nitric oxide (NO). We have examined the responses of isolated pulmonary arterioles from prenatal and postnatal rats with and without nitrofen (2,4-dichlorophenyl-p-nitrophenyl ether)-induced CDH to a variety of activators of the NO-cyclic guanosine monophosphate (cGMP) pathway. METHODS: Right-sided CDH was induced in fetal rats by feeding nitrofen to pregnant rats on day 12 of gestation. Control rats were fed olive oil (vehicle). Third-generation pulmonary arterioles were isolated from the right lung of prenatal rats at term and from newborn rats within 8 hours after birth. Responses to increasing concentrations of sodium nitroprusside (SNP), atrial natriuretic peptide, or 8-bromo-cGMP were measured in pulmonary arterioles from control rats and from rats with nitrofen-induced CDH. Postnatal responses to 8-bromo-cGMP were also recorded in the presence of zaprinast, a type V phosphodiesterase inhibitor. RESULTS: Pulmonary arterioles from prenatal rats did not dilate in response to SNP, atrial natriuretic peptide, or 8-bromo-cGMP. Vasodilatory responses of postnatal pulmonary arterioles from control rats to SNP and 8-bromo-cGMP were significantly greater than for arterioles from rats with CDH. Zaprinast pretreatment resulted in similar responses for postnatal CDH and control arterioles to 8-bromo-cGMP. CONCLUSIONS: Postnatal pulmonary arterioles from CDH rats exhibit altered nitrovasodilator responsiveness, which may be due to rapid degradation of cGMP.

Animals↗

A surgeon in your corner.

The surgical emergencies presented in this article encompass the vast majority of the nontraumatic emergencies seen by a pediatric surgeon but represent only a small proportion of surgical disease in children. Most children seeking outpatient medical care do not need a surgeon, but those who do need one quickly. When one of the processes detailed above is suspected, it is always best to avail oneself of the opinion of a surgeon in a timely manner.

Airway Obstruction↗

Repetitive deformation and pressure activate small bowel and colonic mucosal tyrosine kinase activity in vivo.

Physical forces like deformation and pressure modulate signaling and phenotype in cultured cells. However, it is more difficult to establish that such phenomena occur in vivo. We studied the effects of 0 to 10 minutes of rhythmic distension with an isotonic electrolyte and polyethylene glycol solution to 30 cm H(2)O pressure on defunctionalized small and large bowel segments in adult male Sprague Dawley rats. Mucosa was harvested at 0, 1, and 10 minutes and assayed for tyrosine kinase activity. Rhythmic distension caused a time-dependent increase in colonic mucosal tyrosine kinase activity, which was statistically significant at 10 minutes (140% +/- 41% increase, n = 5, P <.05). Small bowel tyrosine kinase activity was markedly lower than that observed in the colon, but achieved a statistically significant increase at 5 minutes after initiation of rhythmic distension. (115% +/- 44% increase, n = 5, P <.05).

Animals↗