Laparoscopic nephrectomy in crossed fused kidney ectopia with severe hydronephrosis in 2 year-old child

Introduction: There are no specific recommendations for the surgical management of crossed fused renal ectopia (CFRE), but a laparoscopy has been proposed in a limited number of children. We report the case of a complex CFRE with severe hydronephrosis in a child treated by laparoscopic nephrectomy. Case report: A 2-year-old boy was admitted for hip and abdominal pain. A CFRE was diagnosed. Laparoscopic nephrectomy was suggested. The right crossed ectopic kidney appeared fused at its upper pole to the lower pole of the left kidney. The left kidney was in total rotation postero superiorly The left ureter crossing over the ectopic dilated right pelvis deliniated the fusion line between both kidneys. The right ureter was dissected distally. The right artery and vein were dissected and the right kidney pelvis opened making the separation of the kidneys easier and so reducing the danger of damaging the lower pole of the left kidney. During the dissection an aberrant vein arising from the left iliac vein and draining from both kidneys was identified. The right vein was dissected preserving the left vein, and the nephrectomy completed. Conclusions: Laparoscopy is a recommended option to treat CFRE, offering all advantages of this approach

Bright expression of CD91 identifies highly activated human dendritic cells that can be expanded by defensins

CD91 is a scavenger receptor expressed by different immune cells and its ligands defensins have been demonstrated to contribute to immune responses against infections and tumors. We previously demonstrated that CD91 is expressed on human monocyte-derived dendritic cells (moDCs) and that human defensins stimulate in vitro the activation of these cells. In this study, we observed that CD91 is expressed at different levels on two distinct moDC subsets: CD91dim and CD91bright moDCs. Although CD91bright moDCs represented a small proportion of total moDCs, this subset showed higher levels of activation and maturation markers compared to CD91dim moDCs. The frequency of CD91bright moDCs increased by ~50% after in vitro stimulation with recombinant Human Neutrophil Peptide-1 (rHNP-1) and recombinant Human Beta Defensin-1 (rHBD-1), while lipopolysaccharide (LPS) stimulation decreased it by ~35%. Both defensins up-regulated moDC expression of CD80, CD40, CD83 and HLA-DR, although to a lower extent compared with LPS. Notably, upon culture with rHNP-1 and rHBD-1, CD91bright moDCs maintained their higher activation/maturation status, while this was lost upon culture with LPS. Our findings suggest that defensins promote the differentiation into activated CD91bright DCs and may encourage the exploitation of the CD91/defensins axis as a novel therapeutic strategy to potentiate antimicrobial and antitumor immune response

More favorable metabolic impact of three-times-weekly versus daily growth hormone (GH) treatment in na\uefve GH-deficient children

OBJECTIVE: Growth hormone treatment (GHT) is commonly administered daily, although pulsatile GH secretion is unlikely to be achieved. The auxological effect of a three-injections-per-week (TIW) regimen is controversial, while the metabolic effects have been never evaluated in children. The objective was to evaluate whether two different regimens of weekly injections could lead to similar auxological and metabolic effects in children with GH deficiency (GHD). DESIGN: 32 GHD children (25 males, mean age 10.5 \ub1 2.2 yr) were randomly assigned to receive daily (group A, No 16) or TIW (group B, No 16) GHT for 12 months. METHODS: Auxological parameters, insulin-like growth factor-I (IGF-I), glucose and insulin during OGTT, glycosylated hemoglobin (HbA1c), lipid profile, the oral disposition index (DIo), the homeostasis model assessment estimate of insulin resistance (Homa-IR) and the insulin sensitivity index (ISI). RESULTS: After 12 months, both groups showed a significant and comparable improvement in height (p<0.001) and IGF-I (p<0.001). As regards the metabolic parameters, in both groups we found a significant increase in fasting insulin (p<0.001 and p=0.026) and Homa-IR (p<0.001 and p=0.019). A significant increase in fasting glucose (p=0.001) and a decrease in ISI (p<0.001) and DIo (p=0.002) were only found in group A. CONCLUSIONS: The TIW regimen is effective and comparable with the daily regimen in improving auxological parameters and has a more favorable metabolic impact in GHD children (www.ClinicalTrials.gov. NCT03033121)

Modelling of an intersubband quantum confined Stark effect in Ge quantum wells for mid-infrared photonics

: In this work we theoretically investigate quantum confined Stark effect of intersubband transitions in asymmetric Ge/SiGe quantum wells for intensity modulation in the mid-infrared. Our calculations show that extinction ratios up to 1 dB and modulation speeds of several tens of GHz could be obtained in 100 µm long waveguides

Microenvironment in neuroblastoma: Isolation and characterization of tumor-derived mesenchymal stromal cells

Background: It has been proposed that mesenchymal stromal cells (MSCs) promote tumor progression by interacting with tumor cells and other stroma cells in the complex network of the tumor microenvironment. We characterized MSCs isolated and expanded from tumor tissues of pediatric patients diagnosed with neuroblastomas (NB-MSCs) to define interactions with the tumor microenvironment. Methods: Specimens were obtained from 7 pediatric patients diagnosed with neuroblastoma (NB). Morphology, immunophenotype, differentiation capacity, proliferative growth, expression of stemness and neural differentiation markers were evaluated. Moreover, the ability of cells to modulate the immune response, i.e. inhibition of phytohemagglutinin (PHA) activated peripheral blood mononuclear cells (PBMCs) and natural killer (NK) cytotoxic function, was examined. Gene expression profiles, known to be related to tumor cell stemness, Wnt pathway activation, epithelial-mesenchymal transition (EMT) and tumor metastasis were also evaluated. Healthy donor bone marrow-derived MSCs (BM-MSC) were employed as controls. Results: NB-MSCs presented the typical MSC morphology and phenotype. They showed a proliferative capacity superimposable to BM-MSCs. Stemness marker expression (Sox2, Nanog, Oct3/4) was comparable to BM-MSCs. NB-MSC in vitro osteogenic and chondrogenic differentiation was similar to BM-MSCs, but NB-MSCs lacked adipogenic differentiation capacity. NB-MSCs reached senescence phases at a median passage of P7 (range, P5-P13). NB-MSCs exhibited greater immunosuppressive capacity on activated T lymphocytes at a 1:2 (MSC: PBMC) ratio compared with BM-MSCs (p = 0.018). NK cytotoxic activity was not influenced by co-culture, either with BM-MSCs or NB-MSCs. Flow-cytometry cell cycle analysis showed that NB-MSCs had an increased number of cells in the G0-G1 phase compared to BM-MSCs. Transcriptomic profiling results indicated that NB-MSCs were enriched with EMT genes compared to BM-MSCs. Conclusions: We characterized the biological features, the immunomodulatory capacity and the gene expression profile of NB-MSCs. The NB-MSC gene expression profile and their functional properties suggest a potential role in promoting tumor escape, invasiveness and metastatic traits of NB cancer cells. A better understanding of the complex mechanisms underlying the interactions between NB cells and NB-derived MSCs should shed new light on potential novel therapeutic approaches

Flank sliding: A valve and a sentinel for paroxysmal eruptions and magma ascent at Mount Etna, Italy

Rising magma, dike intrusions, and flank collapse are observed at many volcanoes worldwide, but how they interact is still poorly documented. Extensive synthetic aperture radar interferometry and continuous global positioning system observations captured a sharp dike intrusion at Mount Etna, Italy, during the 2018 paroxysm that triggered a vigorous seaward sliding of the eastern flank connected with brittle failure and deep magmatic resourcing. We propose a feedback process between flank acceleration and magma intrusion that derives from the interaction between the long- and short-term deformation of the volcano. The flank sliding acts as a valve that modulates the emplacement and eruption of magma within the shallow system. Rapid flank acceleration could potentially evolve into sudden collapses and seismic release at shallow depth. In turn, flank slip events could act as a sentinel for changes in magma depth and paroxysmal eruptions at Mount Etna

Anthropogenic sinkholes of the city of Naples, Italy: an update

In recent years, the study of anthropogenic sinkholes in densely urbanized areas has attracted the attention of both researchers and land management entities. The city of Naples (Italy) has been frequently affected by processes generating such landforms in the last decades: for this reason, an update of the sinkhole inventory and a preliminary susceptibility estimation are proposed in this work. Starting from previous data, not modified since 2010, a total of 270 new events occurred in the period February 2010–June 2021 were collected through the examination of online newspapers, local daily reports, council chronicle news and field surveys. The final consistence of the updated inventory is of 458 events occurred between 1880 and 2021, distributed through time with an increasing trend in frequency. Spatial analysis of sinkholes indicates a concentration in the central sector of the city, corresponding to its ancient and historic centre, crossed by a dense network of underground tunnels and cavities. Cavity-roof collapse is confirmed as one of the potential genetic types, along with processes related to rainfall events and service lines damage. A clear correlation between monthly rainfall and the number of triggered sinkholes was identified. Finally, a preliminary sinkhole susceptibility assessment, carried out by Frequency Ratio method, confirms the central sector of city as that most susceptible to sinkholes and emphasizes the predisposing role of service lines, mostly in the outermost areas of the city

Multisource data integration to investigate one century of evolution for the Agnone landslide (Molise, southern Italy)

Landslides are one of the most relevant geohazards worldwide, causing direct and indirect costs and fatalities. Italy is one of the countries most affected by mass movements, and the Molise region, southern Italy, is known to be susceptible to erosional processes and landslides. In January 2003, a landslide in the municipality of Agnone, in the Colle Lapponi-Piano Ovetta (CL-PO) territory, occurred causing substantial damage to both structures and civil infrastructure. To investigate the evolution of the landslide-affected catchment over approximately one century, different data were taken into account: (i) literature information at the beginning of the twentieth century; (ii) historical sets of aerial optical photographs to analyse the geomorphological evolution from 1945 to 2003; (iii) SAR (Synthetic Aperture Radar) data fromthe ERS1/2, ENVISATand COSMO-SkyMed satellites tomonitor the displacement from 1992 to 2015; (iv) traditional measurements carried out through geological and geomorphological surveys, inclinometers and GPS campaigns to characterize the geological setting of the area; and (v) recent optical photographs of the catchment area to determine the enlargement of the landslide. Using the structure from motion technique, a 3D reconstruction of each set of historical aerial photographs was made to investigate the geomorphological evolution and to trace the boundary of the mass movements. As a result, the combination of multitemporal and multitechnique analysis of the evolution of the CL-PO landslide enabled an assessment of the landslide expansion, which resulted in a maximum length of up to approximately 1500 m. A complete investigation of the past and present deformational sequences of the area was performed to potentially plan further mitigation and prevention strategies to avoid possible reactivations

Chirality effects on the IRMPD spectra of basket resorcinarene/nucleoside complexes

The IRMPD spectra of the ESI-formed proton-bound complexes of the R,R,R,R- and S,S,S,S-enantiomers of a bis(diamido)-bridged basket resorcin[4]arene (R and S) with cytosine (1), cytidine (2), and cytarabine (3) were measured in the region 2800– 3600 cm1. Comparison of the IRMPD spectra with the corresponding ONIOM (B3LYP/6-31(d):UFF)-calculated absorption frequencies allowed the assessment of the vibrational modes that are responsible for the observed spectroscopic features. All of the complexes investigated, apart from [R·H·3]+, showed similar IRMPD spectra, which points to similar structural and conformational landscapes. Their IRMPD spectra agree with the formation of several isomeric structures in the ESI source, wherein the N(3)-protonated guest establishes noncovalent interactions with the host amidocarbonyl groups that are either oriented inside the host cavity or outside it between one of the bridged side-chains and the upper aromatic nucleus. The IRMPD spectrum of the [R·H·3]+ complex was clearly different from the others. This difference is attributed to the effect of intramolecular hydrogen bonding interactions between the C(2’)-OH group and the aglycone oxygen atom of the nucleosidic guest upon repulsive interactions between the same oxygen atom and the aromatic rings of the host

Music benefits on postoperative distress and pain in pediatric day care surgery

Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (P&lt;0.001). Positive impact on reactions to pain was noted using the FLACC scale. Music improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age