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Biomedical subjects

L Lucarini

Publications and source records attributed to L Lucarini.

18 recordsLinked to original sources

Detection of common and private mutations in the COL6A1 gene of patients with Bethlem myopathy.

BACKGROUND: Dominant mutations in COL6A1, COL6A2, and COL6A3, the three genes encoding collagen type VI, a ubiquitous extracellular matrix protein, are associated with Bethlem myopathy (BM) and Ullrich scleroatonic muscular dystrophy. METHODS: The authors devised a method to screen the entire coding sequence of the three genes by reverse transcriptase-PCR amplification of total RNA from skin fibroblasts and direct sequencing of the resulting 25 overlapping cDNA fragments covering 107 exons. RESULTS: Four splicing and four missense mutations were identified in 16 patients with BM, six of which are novel mutations in COL6A1. Both common and private mutations are localized in the alpha1 (VI) chain between the regions corresponding to the 3' end of the NH2-globular domain and the 5' end of the triple helix, encoded by exons 3 through 14. CONCLUSIONS: The clustering of the mutations in a relatively narrow area of the three collagen type VI chains in patients with Bethlem myopathy (BM) suggests that mutations in different regions could result in different phenotypes or in no phenotype at all. Moreover, the detection of mutations in only 60% of the patients suggests the existence of at least another gene associated with BM. The authors propose the direct sequencing of COL6 cDNAs as the first mutation screening analysis in BM, given the high number of exon-skipping events.

Adolescent↗

Cytokine gene expression and production by human LPS-stimulated mononuclear cells are inhibited by sulfated heparin-like semi-synthetic derivatives.

BACKGROUND: The K5 polysaccharide obtained from Escherichia coli strain 010:K5:H4 is a polymer of the disaccharidic unit formed by D-glucuronic acid and N-acetylglucosamine. This structure is akin to N-acetylheparosan, the precursory polymer of heparin and of heparan sulfate. This structural affinity with N-acetylated heparin and with de-sulfated heparin makes the K5 polysaccharide extremely useful for the preparation of sulfated heparin-like semi-synthetic derivatives. It has been demonstrated that heparins are able to inhibit tissue factor and cytokine production and expression by human monocytes. OBJECTIVE: The aim of this study was to evaluate the effects of four different heparin-like semi-synthetic derivatives on inflammatory cytokine production and expression by human mononuclear cells. RESULTS: The simultaneous addition of lipopolysaccharide (LPS; 0.2 and 10 micro g mL(-1)) and the K5 polysaccharide did not inhibit interleukin (IL)-1beta, IL-6 or tumor necrosis factor (TNF)-alpha production by stimulated mononuclear cells. IL-1beta, IL-6 and TNF-alpha concentrations in supernatants of LPS-stimulated mononuclear cells were not influenced by the addition of N,O-sulfated K5 polysaccharide (K5-N, OS) and epimerized N-sulfated K5 polysaccharide (K5 NS epi) at 5 and 10 microg mL(-1), whereas the addition of epimerized N,O-sulfated K5 polysaccharide (K5-N, OS epi) (5 and 10 microg mL(-1)) and O-sulfated K5 polysaccharide (K5-OS) (5 and 10 microg mL(-1)) to LPS-stimulated cells caused a significant dose-dependent inhibition of IL-1beta, IL-6 and TNF-alpha. All sulfated heparin-like semi-synthetic derivatives did not influence the IL-10 production by LPS-stimulated mononuclear cells. In LPS-stimulated cells (0.2 and 10 microg mL(-1)), K5-OS or K5-N, OS epi at 5 and 10 microg mL(-1) markedly decreased TNF-alpha mRNA expression. CONCLUSIONS: These results indicate that the sulfated heparin-like semi-synthetic derivatives K5-OS and K5-N, OS epi are able to inhibit both expression and production of inflammatory cytokines, whereas they do not influence the anti-inflammatory cytokine IL-10, suggesting a potential role for these products as modulators of inflammatory reactions.

Bacterial Capsules↗

New technique for optical control of the first trocar insertion.

BACKGROUND: In laparoscopic surgery serious complications caused by the blind insertion of the first trocar have been reported even after the pneumoperitoneum is established by means of a Veress needle. As a consequence, some techniques to safely insert the first port have been developed. Many surgeons advocate a minilaparotomy to position the first port. However, especially in obese patients, the dissection to insert the Hasson's trocar may be difficult and time consuming. As an alternative, optical disposable trocars have been studied and produced to be safely positioned under direct visualization. METHODS: A new technique to insert, under adequate optical control, a non disposable standard port is described. Personal experience in 126 consecutive patients is reviewed. Data were recorded prospectically and insertion time was recorded in every case. RESULTS: Medium time of trocar insertion was 55 sec (range 30-160 sec). Identification of distinct layers of the abdominal wall was always possible. There were no complications related to the insertion of the first reusable cannula under visual control. CONCLUSIONS: This technique may be considered a safe, simple and cost effective method to insert the first trocar.

Adult↗

Laparoscopic-assisted Hartmann's reversal with the Dexterity Pneumo Sleeve.

Several laparoscopic techniques of Hartmann reversal have been published. An alternative laparoscopic-assisted procedure, essentially aseptic, which uses the minilaparotomy for colostomy mobilization to apply the Dexterity Pneumo Sleeve device is described. This technique combines the advantages of the minimally-invasive approach with the direct access of the surgeon's hand to the patient's abdomen.

Asepsis↗

[Mechanical staplers. Our experience].

The Authors report their experience concerning 237 stapled sutures performed during 93 gastro-intestinal operations. Intraoperative technical advantages are described and improved postoperative courses are outlined; in particular earlier recovery of intestinal function, minimal rate of complications and 11-day average post-operative stay are reported.

Adolescent↗

[Heterotopic autotransplant of the spleen after splenectomy in traumatic rupture. Personal experience and scintigraphic follow-up].

Certain aspects of OPSI (Overwhelming Post-Splenectomy Infection) are examined, mainly its considerable gravity, its relatively high incidence, especially in children; its difficult prophylaxis with a report on personal experience of ectopic autotransplant of spleen tissue in two young patients after splenectomy for traumatic rupture. The technique was found to be simple and quickly performed. Scintigraphic follow-up for over 4 years after the operation showed satisfactory growth in the transplanted spleen tissue.

Adolescent↗

[Analysis of surgical treatment of 592 cases of cancer of the stomach].

A series of 592 cases of gastric carcinoma operated on between January 1960 and December 1974 at the S. Croce Hospital at Cuneo is reported. The following observations were made: greater frequency in males (68.25%). The following localizations: cardiac portion 31 cases; fundus 20; body 93 and antropyloric 249. Cancer ulcer in 5.06% of cases. Cancer on the gastric stump in ulcer resections in two cases. The following operations were performed: Gastric resection in 325 cases: operative mortality (O.M.) 5%; 5-year survival: 18%. Total gastrectomy in 38 cases: O.M. 13.1%; 2-year survival: 21%, 5-year survival 5.2%. E.A.G. in 61 cases; O.M. 17.8%; survival: 6 months; maximum 26 months. Gastrostomy in 16 cases; Expl. laparotomy in 150 cases. Survival was only a few months in these two latter groups. Out of all operations 5-year survival was 6.7% and 27.4% in so-called curative interventions. In principle, gastric resection is still considered to be the most valid approach.

Adenocarcinoma↗

[Acute enzymatic pancreatitis. Clinical contribution].

Personal experience with acute enzymatic pancreatitis in 113 cases observed, over 11 years, at the Santa Croce Hospital Surgical Division is described. Only 58 cases (51,3%) were submitted to surgery and the remaining 55 cases (48,7%) were treated with medical therapy. A mortality of 16,8% was observed.

Acute Disease↗

[Carcinoma of the colon and rectum. Our experience in 395 cases observed in a period of 10 years 1963-1973].

A personal series of 395 cases of malignant tumours of the large intestine observed at the Surgical Division of the Cuneo Hospital from 1963 to 1973 is reported. Of the series examined, 206 cases involved the sigmoid colon and rectum and 33 the remaining colon. The percentage in which radical surgery was possible was of the order of 52%. Survival at 5 years after the operation was: 1) carcinoma of the colon 30%, 2) of the sigmoid 42.1% and 3) of the rectum 45%.

Adult↗

[Problems inherent in the diagnosis and treatment of common bile duct calculi during video-laparoscopic cholecystectomy. Report on 700 cases, February 1991 to December 1997].

Conditions of predictivity seem to make treatment of common bile duct (CBD) stones during VLC more safe and adequate. IV cholangiography (or, nowadays, MRI and echoendoscopy) drive to a selective use of ERCP and cholangiography, help to reduce the incidence of residual lithiasis and give a "topographical map" of the CBD that can be useful, during VLC, in the search of the hilum structures, especially when the anatomical situation is not clear.

Ampulla of Vater↗

[Limitations of laparoscopic cholecystectomy].

Laparoscopic cholecystectomy has brought about an important and to some extent provocative revolution introducing the new dimension of minimally invasive surgery. The intrinsic limits of this new technique are analysed, as well as those that need to be established for its adoption to respect the rules of traditional surgery. Author's experience suggests that the explorative stage is widely indicated as a first step. This does not preclude early, reasoned and cautious conversion to laparotomy, but allows a safe and more generous use of the technique thanks to the possibility to check on patient selection.

Adolescent↗