[Intestinal intussusception: easy diagnosis in the 21st Century? Outcome of five years experiences]. / Invaginazione intestinale: una diagnosi facile nel 21 degrees secolo? Outcome degli ultimi 5 anni.

UNLABELLED: Intussusception is an entity well codify in pediatric surgery, with guidelines well defined since years in terms of imaging and procedures. MATERIAL: From January '99 to Dec. '03, 25 children were admitted to the Department of Pediatric Surgery of the Children's Hospital of Milan. All the aspects related to the pathology have been evaluated in the study. RESULTS: 25 patients have been studied. 23/25 presented severe pain, 19/25 normal bowel movements in the last 3 hours and in 9/25 a mass were detected at clinical examination.19/25 were submitted to laparotomy after failure of reduction through barium enema, and in 17/19 a manual reduction were performed. Only 2 patients required a bowel resection with primary anastomosis. The analysis of the delay of diagnosis, the delta-T between beginning of the symptoms and first medical evaluation was of 16,23 h. (3-72), and the delta-T between the first evaluation and diagnosis was 18,7 h. The interval between diagnosis and surgery was of 4,3. CONCLUSION: Authors believe that intussusception still represent a challenge for medical and surgical emergency team, supported by the data in literature. Imaging procedures must not be constricted in case of minimal suspicions of intestinal intussusception.

Ca2+/phospholipid-binding and syntaxin-binding of native synaptotagmin I.

Synaptotagmin, a synaptic vesicle protein endowed with multiple properties, is the putative calcium sensor in neuroexocytosis. Ca2+/phospholipid binding and syntaxin binding activity of synaptotagmin were previously investigated using recombinant fusion proteins. In phospholipid binding the EC50 for calcium obtained was different when fusion proteins containing one (C2A) or both (C2A+C2B) binding domains were used. It was alternatively proposed that one or both synaptotagmin binding domains are important for calcium-sensing and triggering of transmitter release. In this study the binding activity of native full-length synaptotagmin, immobilized on beads, was investigated. We found the kinetic parameters of Ca2+/phospholipid binding to be compatible with the role of calcium sensor for synaptotagmin (EC50 for calcium = 72 +/- 7 microM), with the two C2 domains supporting separate and complementary calcium sensing properties. The binding of native syntaxin to synaptotagmin was measurable in the absence of calcium, but was markedly stimulated (2.2-fold) in the presence of mM calcium. It may be speculated that the two domains have a synergistic action in fast synchronous transmitter release, whereas C2B domain alone may support slow asynchronous release, working as a high affinity calcium sensor.