66 research outputs found
Utilizzo di precursori muscolari scheletrici e precursori derivati da sistema neuroenterico nella correzione di difetti sfinteriali
No full textThis project rises from the hypothesis of using cell therapy and tissue engineering in the gastrointestinal system. The clinical environment the project borne is the Pediatric Surgery. However the faced topics embrace all age population. In particular we explored the possible correction of sphincter defect by using skeletal muscle precursors. In this view we studied the capability of skeletal muscle precursors (committed stem cells) of integrating into contractile tissue of gut. In vitro and in vivo experiments have been done. The most data have been obtained from the murine model of cryo-injury of gastroesophageal junction. We studied the regeneration after injection of cultured or freshly isolated satellite cell (obtained by the single fibre technique) compared with other cell populations. The candidate personally managed several technique to obtain skeletal muscle precursors, primary cell culture, co-culture between various cell-type; analysis techniques ( conventional histology, immunofluorescent analysis of cryo-sections, western-blotting, cytofluorimetric anlysis, statistical analysis, microscopy imaging). Further micro-surgery techniques have been used in the in vivo experiments on small animals. Results have been presented in international meetings or publications:
- Murine Muscle Precursor Cells survived and integrated in a Cryoinjured Gastroesophageal Junction.
Fascetti Leon F, Malerba A, Boldrin L, Leone E, Betalli P, Pasut A, Zanon GF, Gamba PG, Vitiello L, DeCoppi P. J Surg Res. Epub 2007 Jun 19
- Muscle precursors injection in the gastroesophageal junction: further experience.
Fascetti Leon F, Malerba A, Boldrin L, Zanon GF, Gamba PG, Pierro A, De Coppi P. Oral presentation at the 8th European Congress of Paediatric Surgery (EUPSA) Turin, Italy 2007
In vitro enhancement of muscle precursors cells differentiation enhanced by co-cultures with neurogenic cells. A Malerba, F Fascetti Leon, L Boldrin, C Caldwell, N, Thapar, A Pierro, P De Coppi British Association of Paediatric Surgeons (BAPS) annual meeting Edimburgh, UK 2007
- Further experience with the injection of muscle precursors in the gastroesophageal junction
Fascetti Leon F, Malerba A, Boldrin L, Vitello L, Talenti E, Zanon GF, Gamba PG, Pierro A, De Coppi P. presentation at the American Paediatric Surgeons Association (APSA) Orlando, Florida 2007
- Long term integration of muscle precursor cells injected in the lower esophageal sphincter.
Fascetti Leon F, Malerba A, Boldrin L, Betalli P, Gamba PG, Vitiello L, A. Pierro, DeCoppi P. submitted.
Cell culture have been conduced at the Regenerative Medicine Lab of Della Città della Speranza (c/o Dipartimento di Pediatria e Istituto VIMM). Part of the analyses and the co-culture have been conduced at the Institute of Child Health - Great Ormond Street Hospital of London. The in vivo section have been done at The work allows the conclusion that adult skeletal muscle precursors could be used in the regeneration of digestive tract contractile tissue. In particular good engrafting and data regarding the possible trans-differentiation through smooth muscle lineage led to follow this approach (correction of sphincter defect). Few data have been obtained from the preliminary experiments on anal sphincter. Furthermore, the capability of integrating and interacting in vitro between ganglion derived cells and muscle cells, let us think to the possible wilder application to gastro-intestinal contraction defects.Il progetto di ricerca nasce dall’ipotesi dell’utilizzo di approcci di terapia cellulare ed ingegneria tissutale nel tratto digerente. L’ambiente clinico da cui nasce lo spunto per questo progetto di ricerca è la Chirurgia Pediatrica. Tuttavia le tematiche affrontate abbracciano trasversalmente ogni fascia di età. Ci si è interessati in particolare alla possibilità di correggere difetti “sfinteriali” tramite l’utilizzo di precursori derivati dal muscolo scheletrico.
In tale ottica sono state esplorate le capacità di integrazione nel tessuto contrattile del tubo digerente di precursori cellulari del muscolo scheletrico (cellule staminali committed). Sono stati eseguiti esperimenti in vivo e in vitro. La maggior parte dei dati sono stati ottenuti utilizzando un modello di danno da congelamento a carico della giunzione gastro-esofagea di topo. Sono state esplorate le possibilità di rigenerazione dopo iniezione di cellule satellite coltivate o a fresco ottenute con la tecnica della singola fibra.
Il candidato ha personalmente utilizzato diverse tecniche per l’ottenimento di precursori staminali da muscolo scheletrico, colture cellulari primarie, coculture tra vari tipi cellulari, nonché varie tecniche di analisi (istologia convenzionale, analisi d’immunofluorescenza delle criosezioni, western-blotting, citofluorimetria, analisi statistica e d’immagine microscopica). Per gli esperimenti in vivo,inoltre, sono state utilizzate tecniche di microchirurgia sul piccolo animale.
Risultati del lavoro svolto sono stati oggetto di presentazioni in congressi nazionali ed internazionali:
- Murine Muscle Precursor Cells survived and integrated in a Cryoinjured Gastroesophageal Junction.
Fascetti Leon F, Malerba A, Boldrin L, Leone E, Betalli P, Pasut A, Zanon GF, Gamba PG, Vitiello L, DeCoppi P. J Surg Res. Epub 2007 Jun 19
- Muscle precursors injection in the gastroesophageal junction: further experience.
Fascetti Leon F, Malerba A, Boldrin L, Zanon GF, Gamba PG, Pierro A, De Coppi P. Oral presentation at the 8th European Congress of Paediatric Surgery (EUPSA) Turin, Italy 2007
In vitro enhancement of muscle precursors cells differentiation enhanced by co-cultures with neurogenic cells. A Malerba, F Fascetti Leon, L Boldrin, C Caldwell, N, Thapar, A Pierro, P De Coppi British Association of Paediatric Surgeons (BAPS) annual meeting Edimburgh, UK 2007
- Further experience with the injection of muscle precursors in the gastroesophageal junction
Fascetti Leon F, Malerba A, Boldrin L, Vitello L, Talenti E, Zanon GF, Gamba PG, Pierro A, De Coppi P. presentation at the American Paediatric Surgeons Association (APSA) Orlando, Florida 2007
- Long term integration of muscle precursor cells injected in the lower esophageal sphincter.
Fascetti Leon F, Malerba A, Boldrin L, Betalli P, Gamba PG, Vitiello L, A. Pierro, DeCoppi P. submitted.
Gli esperimenti “in vivo” e ‘analisi istologica sono stati condotti presso il Centro inter-dipartimentale Vallisneri dell’Unioversità di Padova.
Le colture cellulari sono state eseguite presso il Laboratorio di Medicina Rigenerativa Della Città della Speranza (c/o Dipartimento di Pediatria e Istituto VIMM).
Parte dell’analisi e delle co-culture sono state eseguite presso l’Institute of Child Health - Great Ormond Street Hospital di Londra.
Il lavoro svolto porta alla conclusione che cellule precursori muscolari derivati da tessuto muscolare scheletrico adulto sono potenzialmente utilizzabili nella rigenerazione delle strutture contrattili del tubo digerente. In particolare la buona capacità di integrazione e dati sulla possibile trans-differenziazione verso la linea cellulare muscolare liscia stimolano a proseguire nella direzione di una terapia cellulare dei difetti sfinteriali. Pochi dati sono derivati dagli esperimenti condotti sullo sfintere anale interno, che vanno pertanto considerati preliminari. Inoltre la capacità di integrazione e interazione in vitro tra cellule nervose gangliari e muscolari derivate da muscolo scheletrico fanno pensare ad un più ampio utilizzo nei difetti di contrattilità gastro-intestinali
DOZ047.89: Thoracoscopic (TS) management of early complications after esophageal atresia (EA) correction: single center experience
No full textAnatomy of the thorax
No full textTyping “anatomy” or “interactive anatomy” into the search-window of any web browser elicits information on hundreds of potentially useful websites. Most are very helpful in learning what is needed to pass an examination or to prepare a surgical intervention accurately. However, accurate anatomical descriptions for any one approaching thoracic pediatric surgery are needed, and which are the basis of this chapter
The Different Approaches of Single Lung Ventilation in Infants with Pulmonary Malformation
No full textL’ASSISTENZA LAPAROSCOPICA NELLA GASTROSTOMIA PERCUTANEA ENDOSCOPICA (PEG): NECESSITA’ O RISORSA?
No full textPediatric kidney transplantation: is it safe to perform during night-time or day-off?
No full textPurpose: To investigate the impact of after-hours surgery on the outcomes of pediatric kidney transplantation (KT). Methods: Medical records of pediatric KTs performed at a single institution between 2013 and 2021 were retrospectively reviewed. The population was split into three groups according to the incision time and calendar: ordinary day (8.00 AM – 6.30 PM), day-off, and night-time (6.30 PM – 8.00 AM). The following endpoints were compared: ischemia times, length of surgery, complications, delayed graft function (DGF), primary graft non-function (PGNF), and eGFR at three-month follow-up. Results: Ninety-six non-living donor KTs were performed, median age 11 (IQR 4.3–14) years and median body weight 26 (IQR 13–50) kg. Forty-one (43%) were performed during night-time and 28 (29%) during day-off. Ischemia times were similar (p = 0.769, p = 0.536). Day-off KTs presented an extended length of surgery (p = 0.011). Thirty-two complications were reported in 31 KTs. No difference in the overall rate of complications, DGF, PNGF, and three-month eGFR was found (p = 0.669, p = 0.383, p = 0.949, p = 0.093). Post-operative bleedings were more common in days-off (p = 0.003). Conclusion: The number of pediatric KTs performed during after-hours was considerable. Even though similar outcomes were reported, more caution should be focused on the KTs performed in days-off to avoid severe complications
Can real-time near-infrared spectroscopy monitoring detect graft venous thrombosis after pediatric kidney transplantation?
No full textBackground: A prompt detection of graft venous thrombosis might preserve the transplanted organ. A real-time near-infrared spectroscopy (NIRS) monitoring of the allograft perfusion could fulfill this goal. The aim of this work was to report the trend of allograft perfusion (rSO2) after pediatric kidney transplantation (KT) complicated by graft venous thrombosis. Case presentation. An infant, affected by end-stage kidney disease due to posterior urethral valves, underwent non-living donor KT. The allograft presented both arterial and venous variants and required a complex bench surgery reconstruction. The perfusion of the allograft was monitored by real-time transcutaneous NIRS. The early post-operative was conditioned by worsening clinical conditions, and a graft venous thrombosis was detected after four hours since the transplantation. NIRS monitoring lasted for 348 minutes. Median lower pole rSO2-value was 65% (IQR 62–66%), while the median upper pole rSO2-value was 70% (IQR 70–71%). These data reflected the congestion of the lower pole, observed at the end of the transplantation. The lower pole showed inferior rSO2 values (p<0.0001). At the end of the monitoring, the decrease in peripheral rSO2, measured in left lower limb as a benchmark, was consistent with the ongoing hypovolemic shock and severe acute anemia. Conclusion: Transcutaneous NIRS might be a reliable device for monitoring allograft and peripheric perfusion after pediatric KT. The modifications of rSO2 values helped the clinicians manage the patients in the post-operative and early detect acute complications
Fimosi
No full textIn questa pubblicazione, indirizzata alla consultazione del pediatra è raccolta l'esperienza maturata nella gestione dei pazienti con fimosi. La fimosi è una patologia conosciuta da diverse migliaia di anni che presenta un’elevata incidenza nella popolazione pediatrica. La gestione dei pazienti con fimosi è oggetto di discussione, per quanto riguarda l’indicazione terapeutica (timing, finalità e tipo di trattamento), per le ripercussioni psicologiche nell’eventualità di intervento chirurgico, per la definizione della patologia e per i preconcetti culturali esistenti nella nostra società riguardo le implicazioni psicologiche legate alla circoncisione, pratica molto diffusa nel mondo occidentale (la maggior parte della popolazione maschile negli Stati Uniti è circoncisa) che, diversamente da quanto si pensa non compromette la funzionalità sessuale futura
A survival analysis of cuffed tunneled silicon central venous catheters in children affected by short bowel syndrome: A lesson from the past
No full textBackground: Tunneled central venous catheters (CVC) are crucial in the management of children affected by short bowel syndrome (SBS). This work aims to investigate the outcomes of tunneled CVC and to identify factors influencing their survival. Methods: All the children diagnosed with SBS and undergone a procedure of insertion of a tunneled CVC from 2010 to 2019 were included. Demographic data and surgical information about the procedures were collected. Regression models and Kaplan–Meier analysis were performed to estimate the survival. Results: Eighteen patients, eight males (44%), with a median length of residual bowel measuring 72 cm (IQR 50–102 cm), were enrolled. Thirty-nine Broviac CVCs were inserted with a mean number of 2.2 CVCs per patient and 13365 line-days. The overall incidence of complications was 3.2/1000 line-days, and the incidence of central line associated bloodstream infections (CLABSI) was 1.1/1000 line-days. No episode of catheter thrombosis was reported. The median survival was 269 days (IQR 82–1814 days). The survival was negatively influenced by a younger age at insertion (R2 = 0.29; p < 0.001), 2.7 Fr diameter (median survival 76 days; p < 0.001) and the occurrence of complications (median survival 169 days; p = 0.002). The length of residual bowel was a mild risk factor for anticipated removal (OR 1.1; CI95 1.0–1.1; p = 0.05). Conclusion: CVC-related complications negatively influenced the survival of the line. An elder age at insertion together with a larger CVC diameter increased the survival of the line, while a shorter residual bowel was associated with an anticipated removal due to complications
Metachronous Bilateral Ovarian Teratoma: A Germ-line Familial Disorder and Review of Surgical Management Options
No full textBACKGROUND: Germ cell tumors in females are uncommon, and bilateral metachronous ovarian teratoma is even exceptional, with sporadic cases described in the literature.
CASE: We report on a girl in whom a metachronous ovarian teratoma occurred 6 years after the first. The simultaneous onset of germ-line anomalies in other members of the family supports the existence of genetic or environmental factors conferring susceptibility to germ cell lesions.
SUMMARY AND CONCLUSION: The case here illustrated reminds the issue of the appropriate follow-up of these patients and of their families
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