Biomedical subjects

F Arena

Publications and source records attributed to F Arena.

103 records · Page 6Linked to original sources

PubMedDate not supplied

[Inhibin B immunocytochemistry for the prognosis assessment of undescended testis damage in children].

Inhibin B immunocytochemistry of both the alpha- and beta-subunits was studied in testicular biopsies from 18 prepubertal and postpubertal patients, with unilateral or bilateral cryptorchism. The present investigation was carried out to seek any prognostic significance for the expected fertility of such subjects in adulthood. All samples were also evaluated by histological and morphometric assessments, according a 1-6 grading sy-stem. In this way, the individual testicular changes were scored by quantitating tubular and germ cell hypoplasia, Sertoli cell hyperplasia, and peritubular fibrosis, where present. The results showed that in bilateral maldescended testes an unexpected expression often occurred of inhibin B beta-subunit in Sertoli cells, while inhibin B alpha-subunit there did not, denoting an early developmental arrest of the testis. It co-related with the high grade testicular damages, as a poor predictor of spermatogenesis. Unlike, unilateral retained testes mainly expressed inhibin B alpha-subunit, irrespective of tubular changes. In the latter instance, different pathogenetic factors of imbalanced testicular regulation can be perspected, other than the Inhibin-Activin system.

Adolescent↗

PubMedDate not supplied

[Do histologic changes of the upper renal pole in double ectopic ureterocele justify a conservative approach?].

The aim of this study was to review the histology of the upper pole segment in patients with duplex ectopic ureterocele to verify if a less aggressive surgery is justified in the prenatally diagnosed patients. We reviewed the histology of the upper pole segment of 15 consecutive patients with duplex system ectopic ureterocele treated between 1991 and 1999 at the Paediatric Surgery Unit of University Hospital of Messina. The diagnosis of duplex system ectopic ureterocele was made according to the criteria of the Section on Urology of the American Academy of Paediatrics. The histology specimens were assessed for dysplastic, inflammatory and obstructive changes. All 15 patients with duplex system ectopic ureterocele were surgically treated with heminephro-ureterectomy and the surgical specimens were histologically examined. Nine of the 15 patients were prenatally diagnosed. The histology of the upper pole segment of the 9 prenatally diagnosed showed in all patients segmental renal microcystic dysplasia, chondroid metaplasic islands and an inflammatory tubulo-interstitial nephropathy in 6 patients (66.6%) and in 2 (22.2%) nephroblastomatosis. The histology of six the postnatal postnatally diagnosed patients showed in all patients segmental multicystic renal dysplasia, inflammatory tubulo-interstitial nephropathy and segmental parenchymal scars. The upper pole histology of the patients with duplex ectopic ureterocele diagnosed prenatally did not show any evidence of reversible histological change. Considering the histology and the good outcome of patients treated with upper pole nephroureterectomy a less aggressive surgery with preservation of the upper pole does not seem justified.

Humans↗

PubMedDate not supplied

[Acute urine retention: early clinical sign of a rhabdomyosarcoma of the bladder or prostate in children: report of three cases].

Acute urine retention can be the first clinical sign of a rabdomyosarcoma (RMS) of bladder and prostate. This is particularly evident in the age group comprised between 2 and 4 years. The Authors report their experience on three cases of 2 years old males admitted for acute urine retention. One case was diagnosed to have an prostate RMS, the other two a RMS of the bladder. The prostate RMS refused the operation dying 2 years after operation. Of the two cases of RMS of the bladder, one was treated successfully by polychemotherapy treatment, the second, after polychemotherapy underwent a partial cystectomy. The Authors conclude affirming the importance of a ultrasonography of the lower urinary tract in all patients with acute retention of urine, since this could be the first sign of a RMS of prostate or bladder.

Acute Disease↗

PubMedDate not supplied

Bilateral neonatal adrenal abscess. Report of two cases and review of the literature.

Neonatal adrenal abscess is an extremely rare condition. 32 cases, 4 bilateral, have been described in the world literature. We treated successfully other two bilateral cases. We report on this rare condition and review the world literature. In our Department we observed two patients in the neonatal period with abdominal distension, vomiting, irritability and fever. Abdominal ultrasound (US), plain x-ray of the abdomen, intravenous pyelography and computed tomography (CT) of the abdomen were performed. In both cases bilateral suprarenal cystic masses were identified. Vanilmandelic acid, Homovanillic acid and cathecolamines were normal. The two neonates underwent a surgical exploration. Abscesses were found and drained releasing a moderate amount of haemorrhagic and purulent materials from the adrenal glands. Post-operative histology on the surgical specimen showed in both cases an abscess in partial haemorrhagic adrenal glands. No neoplastic cells were observed. The recovery was uneventful and at six months follow-up both patients were well and without signs of adrenal insufficiency. Haematogenous bacteria seeding a normal gland or abscess formation in a previous haemorrhagic gland are the most accredited theories. Neuroblastoma, Wilm's tumor and renal duplication with dilatation of the upper segment must be considered in the differential diagnosis. Percutaneous drainage (+/- biopsy) under CT or US guide should be considered the treatment of choice, followed by surgical exploration when diagnosis is not clear.

Abscess↗

PubMedDate not supplied

[Fetal pseudohypoaldosteronism: rare cause of hydramnios].

PHA is a rare cause of hydramnios, characterized by increased amniotic fluid levels of aldosterone and sodium. Two distinct genetic entities (PHA type I and PHA type II) are included. Both are stemmed by a target organ defect with diminished renal tubular responsiveness to aldosterone. The AA present a case in which pregnancy resulted in a preterm infant with severe hydramnios, metabolic acidosis, hyponatriemia, hyperkaliemia. Salt and fluid replacement significantly improved clinical and metabolic condition. However a growth deficiency (-2 SDS) persists at follow-up.

Adult↗

PubMedDate not supplied

[The immunohistochemical demonstration of intracytoplasmic estradiol in colorectal neoplasms].

Intracytoplasmic estradiol content was studied retrospectively using immunohistochemical procedures in tissue samples from subjects suffering from colorectal cancer. The results obtained reveal the presence of intracytoplasmic estradiol in cancer tissue. In precancerous lesions this presence is rarer and inconstant. Estradiol was not detected in the healthy tissue examined. These data suggest that such tumours may depend to some degree on endocrine factors.

Adenoma↗

PubMedDate not supplied

[Intestinal tuberculosis--a clinical case].

The intestinal tuberculosis is a rare disease in Europe and in North America. It is an important disease because some patients can develop intestinal stricture or subacute intestinal obstruction and, sometimes, tuberculous peritonitis. It is often difficult differentiate intestinal tuberculosis from Crohn's disease or intestinal tumors. The treatment is controversial and may be medical or surgical, but the response to medical therapy is not clear, especially in complicated disease. The authors report a case of ileal tuberculosis treated with surgical therapy.

Adult↗

PubMedDate not supplied

[Hemangioma of the bladder in children: 2 case reports and review of the literature].

Hemangioma of the bladder is a rare benign tumor. Hematuria is the most common symptom of the disease. The Authors report their experience on two isolated cases of bladder hemangioma. The lesions were diagnosed by endoscopy and biopsy. In both cases the hemangiomas were electrocoagulated endoscopically. Follow-up examination after 1 year, has shown complete eradication of the lesion.

Age Factors↗

PubMedDate not supplied

[The role of transforming growth factor-beta (TGF-beta) in the pathogenesis of primary megaureter. A histological and immunocytochemical study].

Histologic and Transforming Growth Factor Beta (TGF-beta) immunostain patterns were sought in resected distal urinary tracts from 17 Primary Megaureter (PM) affected children, referred to surgery. Comparative observations were also carried out on embryonal and fetal ureteral buds of both humans and bovines. A reciprocal resemblance was mainly objectivized between the resected "narrowed" ureters of patients under 18 months, and the fetal ureteral buds at 26th and 38th gestational week. A development delay was irrespectively observed in PM "narrowed" ureters, at the longitudinal muscle-bundles in the parietal juxta-luminal compartment. A consistent TGF-beta immunostain cytoplasmic reaction there selectively depicted the growing mesenchymal lines, including both the undifferentiated single cells and the muscle-like profiled ones. These results agree with very recent reports perspecting a segmental maturation delay as a pathogenetic moment of PM. Because of the acquired potent TGF-beta inhibitory role on myoblasts differentiation, the present study substantiates a persistent TGF-beta role in perinatal ureter dilations.

Animals↗

PubMedDate not supplied

[Videourodynamic findings in the child with enuresis].

Videourodynamic investigation was carried on 62 patients with enuresis (34 females, 28 males). Patients were all grouped in four different clinical types according to the International Continence Society: (Type I) monosymptomatic enuresis nocturnal (24 cases); (Type II) nocturnal and diurnal enuresis without daytime frequency (8 cases); Type III) nocturnal enuresis with daytime frequency (22 cases); (Type IV) nocturnal and diurnal enuresis with daytime frequency and/or urgency (8 cases). In children with monosymptomatic enuresis nocturnal the videourodynamic study revealed, in 85% of cases, a normal bladder; in only 17% of cases was observed a detrusor instability. In patients with Type II enuresis a normal bladder was observed in 6 cases, whereas in two a detrusor instability was present. Among the 22 patients with Type III enuresis, 13 cases (59%) had a detrusor instability, 3 cases (14%) had a vesicosfinteric dyssinergia and 6 (27%) had a normal activity. In this group of patients it was documented in 10 cases a trabeculated bladder together with a vesicoureteral reflux in 4 patients, meatal stenosis and bladder diverticula in other two cases. All patients with Type IV enuresis documented pathological data: detrusor instability in 4 patients, vesico-sfinteric dyssinergia in two and neurogenic non-neurogenic bladder in the other two cases. A severe trabeculated bladder was present in all this cases, with vesico-ureteral reflux in two patient. Maximum cystometric capacity was low in 41 cases (66%), normal in 20 (32%), high in 1 (2%), independently of the types of enuresis.

Adolescent↗

PubMedDate not supplied

[Latex: an allergological emergency? An update and outlook].

Allergy to latex has become an increasing and clinically important problem during last years. Natural rubber latex (NRL) allergy has been acknowledged as a major occupation problem among health-care workers. More recently, NRL allergy also occurs in children with spina bifida and in atopic children. Even patients allergic to various fruits, such as banana and avocado may experience allergic reaction from NRL and vice versa. Different latex allergens have been characterized at the molecular level using varied techniques and heterogeneous latex materials. Little is known about prevalence and clinical relevance of latex sensitization and allergy in the general population although the incidence is increasing in children. The wide spectrum of symptoms of NRL allergy range from mild contact urticaria to asthma and anaphylactic reactions. History is an integral part to identify latex allergy. Different tests (skin prick tests, RAST, Pricking, Use test) have been used to objectively supplement the history. Latex allergy must be prevented by the standardization of medical gloves including the labeling of latex content and allergenicity; furthermore the industrial strategies may also develop new methods of less allergenic gloves and other NRL products.

Child↗

PubMedDate not supplied

[The treatment of varicocele in adolescence].

Varicocele treatment in adolescents should be considered as a prophilactic procedure. It is known, in-fact, that the venous reflux is responsible for damage to the testis that worsen by time. For this reason patients with grade II or III varicocele and reduced size of the testis must be considered for treatment. A right approach to varicocele should consider the different etiopathogenetic factors. Type I varicocele can be easily treated with embolization of the spermatic vein during the diagnostic phlebographic procedure. For type II and III in which is present an iliac hypertension must be considered a surgical correction with selective ligation of intra- and extrafunicular veins together with a microsurgical spermatico-epigastric anastomosis so to allow a better venous drainage of the testis. The Authors present their experience on 20 selected cases of varicocele treated by selective inguinal veins ligation and microsurgical anastomosis. They underline the importance to search and ligate, using the microscope, when dilated, the external spermatic vein or cremasteric (ligated in 9 cases), the deferential veins (ligated in 18 cases) and the gubernacular veins (ligated in 16 cases). These last can be recognized only after testicular exteriorization. It is also important to avoid lymphatic and testicular artery ligation. The results obtained were good with no recurrence, testicular atrophia or hydrocele.

Adolescent↗

PubMedDate not supplied

[Urinary hydrometrocolpos by persistent urogenital sinus; prenatal diagnosis and neonatal management].

Urogenital Sinus (UGS) malformation can be ascribed to an arrest of normal embryonic vaginal development. Neonates with UGS frequently have ambiguous genitalia, rarely the vulva may be normal. The aim of this work is to define the role of prenatal sonography in the diagnosis of UGS associated with hydrocolpos and/or hydrometrocolpos. The Authors report their experience on 3 cases of UGS without ambiguous genitalia with hydrometrocolpos, in which prenatal sonography had shown a cystic dilatation in the pelvis. After birth the 3 neonates presented with female genitalia and a single orifice between the labia. The pelvis sonography showed in all the cases an hydrometrocolpos with a large vagina and a compressed and anteriorly located bladder. Voiding cystourethrogram, genitography and genitoscopy confirmed the presence of an UGS with urinary retention inside the vagina and stenosis of the distal portion of the vagina itself. An early drainage of the capacious vagina was performed in the three patients. There are very few reports in the literature of UGS with hydrometrocolpos diagnosed in utero. The cystic dilatation of the vagina is always misdiagnosed with a distended bladder. In utero, infact, the bladder can not be identified being displaced anteriorly by the vagina. The presence of a fluid-debris level inside the cystic anechoic mass must be considered a crucial finding. Multiple echoes are due to vaginal secretions. Prenatal ultrasound has then a definitive role in detecting an obstructed genital tract. This allows to rapidly drain the vagina relieving urinary tract obstruction.

Drainage↗