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G Buscemi

Publications and source records attributed to G Buscemi.

At least 19 recordsLinked to original sources
PubMed2006

PTFE mesh in renal allograft compartment syndrome.

We report a case of anuria in a 42-year-old female kidney transplant patient that occurred secondary to extrinsic compression from a large kidney being placed extraperitoneally in a small iliac fossa. Prompt reexploration in the immediate postoperative period resulted in salvage of the graft with restoration of kidney function. The abdominal wall was reconstructed using prosthetic mesh, which decreased the compartment pressure within the iliac fossa sufficiently to allow the renal vein patency and the kidney perfusion. We think that this tension-free surgical technique should be applied in those cases in which the retroperitoneal space is less than the size of the kidney to avoid renal allograft compartment syndrome or incisional hernia.

Adult↗
PubMed2006

Intraoperative parathyroid hormone monitoring during parathyroidectomy for hyperparathyroidism in waiting list and kidney transplant patients.

This report describes the use of the intraoperative parathyroid hormone (ioPTH) assay during parathyroidectomy in waiting list and transplanted patients. ioPTH levels were determined in 40 patients on the waiting list for kidney transplantation with secondary hyperparathyroidism who underwent subtotal parathyroidectomy and 9 transplanted patients with tertiary hyperparathyroidism who underwent removal of hyperplasic glands. Rapid PTH levels decreased significantly at each time period; the percentage decrease in rapid PTH levels was 61.3% among patients with IPT II and 70.2% in patients with IPT III at 10 minutes and 86.5% in patients with IPT II and 91% in patients with IPT III at 15 minutes after excision of hypersecreting parathyroid tissue. A decrease of 50% or more from baseline PTH levels at 10 minutes and/or a decrease of 85% or more at 15 minutes predicted successful removal of abnormal parathyroid glands. The application of this technique during subtotal parathyroidectomy has proved useful for correct excision of parathyroid glands among waiting list patients with IPT II, while in kidney transplant patients with IPT III it allowed removal of only the pathological glands with a limited surgical approach.

Adult↗
PubMed2006

Use of marginal donors in kidney transplantation: our experience.

The use of elderly donors has been advocated to expand the organ donor pool because of increased needs and the organ shortage. The aim of this study was to analyze whether the use of elderly donors and marginal kidneys affected the outcome of renal transplantations. Herein we presented data on 126 kidney transplantations performed from January 1996 to September 2003 using 32 marginal donors (group A) and 94 ideal donors (group B). We analyzed the medical and surgical complications and the graft survivals at a median follow-up of 18 months. Medical and surgical complications occurred in 22% and 5% versus 7% and 4% in groups A and B, respectively. The mean cold ischemia time and the mean age were greater for patients undergoing kidney transplantations from marginal donors. No differences were observed in graft survival in groups A and B. In conclusion, our data suggested that with an appropriate strategy and a correct selection of patients, marginal kidneys can be safely used to decrease the gap between demand and supply.

Cadaver↗
PubMed2006

[Laparoscopic treatment of adrenal myelolipoma: case report and review of the literature].

Adrenal myelolipoma is a rare benign, non-functioning tumor consisting of fat and hematopoietic tissues. In January 2005 we had observed an adrenal myelolipoma in 70 year old man. During the follow-up for bladder urothelioma, an abdominal CT revaled a well delineated 4x4 cm homogeneous fatty mass in the right suprarenal area with negative attenuation values. The functional study of adrenal gland was normal. The patient underwent videolaparoscopic right adrenalectomy (Gagner technique). Postoperative course was uneventful. The istological diagnosis showed adrenal myelolipoma. We conclude that videolaparoscopic adrenalectomy should be considered the gold standard treatment for benign adrenal lesions.

Adrenal Gland Neoplasms↗
PubMed2001

Chk2 activation dependence on Nbs1 after DNA damage.

The checkpoint kinase Chk2 has a key role in delaying cell cycle progression in response to DNA damage. Upon activation by low-dose ionizing radiation (IR), which occurs in an ataxia telangiectasia mutated (ATM)-dependent manner, Chk2 can phosphorylate the mitosis-inducing phosphatase Cdc25C on an inhibitory site, blocking entry into mitosis, and p53 on a regulatory site, causing G(1) arrest. Here we show that the ATM-dependent activation of Chk2 by gamma- radiation requires Nbs1, the gene product involved in the Nijmegen breakage syndrome (NBS), a disorder that shares with AT a variety of phenotypic defects including chromosome fragility, radiosensitivity, and radioresistant DNA synthesis. Thus, whereas in normal cells Chk2 undergoes a time-dependent increased phosphorylation and induction of catalytic activity against Cdc25C, in NBS cells null for Nbs1 protein, Chk2 phosphorylation and activation are both defective. Importantly, these defects in NBS cells can be complemented by reintroduction of wild-type Nbs1, but neither by a carboxy-terminal deletion mutant of Nbs1 at amino acid 590, unable to form a complex with and to transport Mre11 and Rad50 in the nucleus, nor by an Nbs1 mutated at Ser343 (S343A), the ATM phosphorylation site. Chk2 nuclear expression is unaffected in NBS cells, hence excluding a mislocalization as the cause of failed Chk2 activation in Nbs1-null cells. Interestingly, the impaired Chk2 function in NBS cells correlates with the inability, unlike normal cells, to stop entry into mitosis immediately after irradiation, a checkpoint abnormality that can be corrected by introduction of the wild-type but not the S343A mutant form of Nbs1. Altogether, these findings underscore the crucial role of a functional Nbs1 complex in Chk2 activation and suggest that checkpoint defects in NBS cells may result from the inability to activate Chk2.

Cell Cycle↗
PubMed2000

Use of tacrolimus and mycophenolate mofetil as induction and maintenance in simultaneous pancreas-kidney transplantation.

Clinical trials using quadruple immunosuppression that include the combination of tacrolimus and mycophenolate mofetil have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas-kidney (SPK) transplantation. In an attempt to obtain a low rejection rate without antibody induction therapy, we undertook a prospective study of combined tacrolimus and mycophenolate mofetil and steroids as primary immunosuppression for SPK transplantation. In this study, we analyzed 17 patients who received low-dose intravenous tacrolimus as induction therapy. This was combined with oral tacrolimus, mycophenolate mofetil, and steroids as the primary immunosuppression regimen. There was a significant reduction of empirically and biopsy-proven rejection with an incidence of 23% (4 patients). Leukopenia, gastroparesis, and gastrointestinal side-effects were the cause of discontinuation of mycophenolate mofetil, or low tacrolimus trough level in those patients who developed rejection. All rejection episodes were easy to treat, and none of them required antibody therapy. The combination of tacrolimus with mycophenolate mofetil without antibody induction therapy is effective in preventing early acute rejection. This combination is safe and effective as an alternative immunosuppressive regimen after SPK transplantation.

Adult↗
PubMed2000

The Saccharomyces cerevisiae SDA1 gene is required for actin cytoskeleton organization and cell cycle progression.

The organization of the actin cytoskeleton is essential for several cellular processes. Here we report the characterization of a Saccharomyces cerevisiae novel gene, SDA1, encoding a highly conserved protein, which is essential for cell viability and is localized in the nucleus. Depletion or inactivation of Sda1 cause cell cycle arrest in G(1) by blocking both budding and DNA replication, without loss of viability. Furthermore, sda1-1 temperature-sensitive mutant cells arrest at the non-permissive temperature mostly without detectable structures of polymerized actin, although a normal actin protein level is maintained, indicating that Sda1 is required for proper organization of the actin cytoskeleton. To our knowledge, this is the first mutation shown to cause such a phenotype. Recovery of Sda1 activity restores proper assembly of actin structures, as well as budding and DNA replication. Furthermore we show that direct actin perturbation, either in sda1-1 or in cdc28-13 cells released from G(1) block, prevents recovery of budding and DNA replication. We also show that the block in G(1) caused by loss of Sda1 function is independent of Swe1. Altogether our results suggest that disruption of F-actin structure can block cell cycle progression in G(1) and that Sda1 is involved in the control of the actin cytoskeleton.

Actins↗
PubMed1999

Complementation of the fol2 deletion in Saccharomyces cerevisiae by human and Escherichia coli genes encoding GTP cyclohydrolase I.

Saccharomyces cerevisiae is so far the only organism where a knock-out mutant in the gene encoding GTP cyclohydrolase I (FOL2) has been obtained. GTP cyclohydrolase I controls the de novo biosynthetic pathway of tetrahydrobiopterin and folic acid. Since deletion of yeast FOL2 leads to a recessive auxotrophy for folinic acid, we used a yeast fol2Delta mutant for an in vivo functional assay of heterologous GTP cyclohydrolases I. We show that the GTP cyclohydrolase I, encoded either by the E. coli folE gene or by the human cDNA, complements the yeast fol2Delta mutation by restoring folate prototrophy. Furthermore the folE-3x allele of the E. coli gene, carrying three base substitutions, failed to complement the yeast fol2Delta defect. This allele behaved as a negative semidominant to the wild type folE and, when overexpressed, completely abolished complementation of fol2Delta by folE. Thus, the yeast fol2 null mutant is a suitable system to characterize mutations in genes encoding GTP cyclohydrolase I.

Alleles↗
PubMed1998

[Laparoscopic approach to appendiceal emergencies. Our experience. Preliminary results].

Laparoscopic surgery in acute appendectomy is a very much debated subject also for skilled teams of mini-invasive surgery. The authors review 25 urgent laparoscopic interventions for acute appendicitis, treating some technical aspects of trocar introduction and Endoloops and EndoGia employment in this field. They conclude by emphasizing that the laparoscopic approach for acute appendicitis is the treatment of choice, considering the good results and the future prospects of laparoscopic versus open surgery.

Acute Disease↗
PubMed1997

[The clinico-instrumental assessment of the vascular status of the uremic patient for the making of a vascular access for hemodialysis].

For almost twenty years the Institute of General Surgery and Organ Transplant at Palermo Polyclinic has dealt with vascular problems arising during the preparation, monitoring and search for vascular access in uremic patients. For a number of years advantage has been taken of the vascular status in uremic patients; in fact, the possibility of creating a long-lasting and efficient vascular access also depends on the optimal use of the patient's vascular resources. The authors briefly describe the clinical and instrumental diagnostic strategy for the approach to a vascular access in uremic patients which must be correct and must respect the vascular resources of a "chronic" patient by definition, for whom hemodialysis is often the only prospect of therapy.

Adult↗
PubMed1996

[Procollagen type I C-propeptide in kidney transplant recipients].

The excessive production of parathormone may persist or return after renal transplantation, so that latent hyperparathyroidism in time may lead to loss of bone mass and of the new kidney; a precocious diagnosis of this disease represents the best preventive measure. On a group of 50 successfully undergone kidney transplant patients (group A: 38 immunosuppression therapy with corticosteroids, azathioprine and cyclosporine A patients; group B: 12 immunosuppression therapy with azathioprine and ciclosporine A patients) we have evaluated also the most common markers of hyperparathyroidism, C-propeptide of procollagen of type I (PICP), that is a product of procollagen degradation and it represents in the serum a direct measure of osteoblastic bone activity. Our results showed alkaline phosphate, osteocalcin and PICP increase, which are index of osteoblastic activity and urinary collagen cross-links pyridinoline and deoxypyridinoline increase which are index of bone osteoclastic activity. The survey revealed a linear significant correlation only between PICP and pyridinoline and cross link deoxypyridinoline (p < 0.05). In this group of patients the only PICP could not have a diagnostic meaning. Owing to the particularly bone metabolism of our patients, that probably feel the effects of hyperparathyroidism of the pre-transplant period, PICP turns out insufficient to study the persistent or returned hyperparathyroidism.

Adult↗
PubMed1996

[Pancreatic harvesting from multiorgan donors for islet transplantation].

The result of human islet isolation procedures to transplant in type I insulin-dependent diabetic patients is significantly conditioned by the technique used for pancreas procurement from multiorgan donor. In fact, during multiorgan procurement, an improper handling of the gland could result in edema or degranulation of the acinar tissue, detrimental for the islet purification step. The surgical technique used by our surgical team, includes some important refinements to obtain the largest quantity and the best quality of purified endocrine material.

Adolescent↗
PubMed1995

[Pseudoaneurysm in pancreatic pseudocysts. Report of a clinical case].

Pancreatitis in a percentage of 1.5% in a pseudocyst, 10% of which are represented as formations of the pseudoaneurysmatic type one of the visceral artery. The authors of the following study present the case of an 86 year old woman with positive anamnesis because of a chronic pancreatitis, who is affected by a symptomatology in the epigastric regione together with hematemesis and melena. An ecography shows at the head level a mass of cm 6.5 hypo ecogena, delimitated by a hyper ecogena band. A TAC, with and without contrast means and integrated by some RM and angio-RM sequences, shows that it is a vascular injury, with the characteristic area on enhancement after the infusion of the contrast means. The patients goes under surgical intervention, showing a trough supplied by a branch of the hepatic artery. The intervention is performed with the tying of the artery, with the drainage of the residual cavity plus the creation of a pancreatic, cystic and jejunum derivation.

Aged↗
PubMedDate not supplied

[Harvesting of the rat pancreas with in-situ perfusion. A microsurgical technic].

One of the principal obstacles to pancreatic islet transplantation is the poor yield of islet from donor pancreas. Many techniques have been designed to increase the yield of islets. The influence of pancreas harvesting technique on islet isolation and function has received little attention. The authors report their experience about pancreas procurement in the rat using a multiorgan harvesting technique according to the original methods of Starzl in the human cadaver donors with in situ liver and pancreas flushing with U.W. solution. Sixty adult male Wistar rats weighting 100 gr. on average entered into our studies and underwent to different techniques of pancreas procurement. Our results demonstrate that the microsurgical multiorgan retrieval technique with in situ U.W. flushing via common iliac artery allows the best islets recovery with a larger number and more vital cells compared with the traditional exanguinatio technique, though it is more expensive and time consuming.

Animals↗
PubMedDate not supplied

[Splenic infarction caused by vascular pedicle torsion].

We report a case of a spleen infarction caused by the vascular pedicle torsion. A 25 year-old-man, heterozygous for HbS, presented with severe abdominal pain especially in the left upper quadrant in front and in the back, fever other symptoms related to acute abdomen. First we excluded most common disease (occlusive one and hematologic one) through conform investigation, then we suspected a spleen problem. So we did further investigation with ultrasonography which showed splenomegaly and the spleen looked twisted with its hilum in contact with previous abdominal wall, moreover (here were are as of decreased signal intensity characteristic of splenic infarction under the capsule and some blood in the Douglas pouch. The patient underwent splenectomy urgently. During the intervention we saw a splenomegaly like the ultrasonography showed, moreover there were a long twisted vascular pedicle and many areas of infarctions, some of which had ruptured causing emoperitoneum. The surgical intervention was successful and the clinical spectrum was solved. The splenic infarction might be clinically silent or to represent a surgical emergency. In front a case of acute abdomen, after exclusion of most common etiology, we underline the importance to suspect a spleen suffering, especially vascular one, when (here was no history of trauma. Considering this fact, a simple not invasive examination like ultrasonography is able to confirm this kind of hypothesis and to give soon information to make the surgical choose.

Adult↗