ABSTRACT
Children may benefit from minimally invasive surgery (MIS) in the correction of Morgagni hernia (MH). The present study aims to evaluate the outcome of MIS through a multicenter study. National institutions that use MIS in the treatment of MH were included. Demographic, clinical and operative data were analyzed. Thirteen patients with MH (6 males) were operated using similar MIS technique (percutaneous stitches) at a mean age of 22.2±18.3 months. Six patients had chromosomopathies (46%), five with Down syndrome (39%). Respiratory complaints were the most common presentation (54%). Surgery lasted 95±23min. In none of the patients was the hernia sac removed; prosthesis was never used. In the immediate post-operative period, 4 patients (36%) were admitted to intensive care unit (all with Down syndrome); all patients started enteral feeds within the first 24h. With a mean follow-up of 56±16.6 months, there were two recurrences (18%) at the same institution, one of which was repaired with an absorbable suture; both with Down syndrome. The application of MIS in the MH repair is effective even in the presence of comorbidities such as Down syndrome; the latter influences the immediate postoperative recovery and possibly the recurrence rate. Removal of hernia sac does not seem necessary. Non-absorbable sutures may be more appropriate.
Subject(s)
Hernias, Diaphragmatic, Congenital/surgery , Herniorrhaphy/methods , Child, Preschool , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Infant , Male , Minimally Invasive Surgical Procedures , Retrospective StudiesABSTRACT
Constitutive secretion of heparan sulphate proteoglycans (HSPGs) was stimulated in human hepatoma HepG2 cells by phorbol 12-myristate 13-acetate (PMA) and inhibited by calphostin C, a specific inhibitor of protein kinase C (PKC). To delineate more closely the site of PKC action, the packaging in vitro of 35SO4-labelled HSPGs into transport vesicles was investigated. Formation of transport vesicles at the trans-Golgi network was stimulated by PMA and inhibited by calphostin C or Ro 31-8220 by using a post-nuclear supernatant. Treatment of either isolated Golgi-enriched membranes or cytosolic proteins with calphostin C provided evidence that membrane-bound PKC forms strongly supported vesicle formation, whereas cytosolic PKC forms showed a marginal effect. The PKC isoforms PKC-alpha and PKC-zeta were attached to highly purified Golgi membranes, as shown by Western blotting. Both isoforms were localized by confocal immunofluorescence microscopy in the Golgi area of HepG2 cells. Immunoelectron microscopy of ultrathin cryosections of HepG2 cells showed that PKC-zeta predominantly attaches to the trans-Golgi region, whereas PKC-alpha binds to the cis- and trans-Golgi area.
Subject(s)
Cytoplasmic Granules/metabolism , Golgi Apparatus/enzymology , Isoenzymes/metabolism , Protein Kinase C/metabolism , Carcinoma, Hepatocellular , Cell Fractionation , Cell Line , Cell-Free System , Egtazic Acid/pharmacology , Enzyme Inhibitors/pharmacology , Heparan Sulfate Proteoglycans , Heparitin Sulfate/biosynthesis , Humans , Indoles/pharmacology , Intracellular Membranes/enzymology , Isoenzymes/analysis , Kinetics , Liver Neoplasms , Naphthalenes/pharmacology , Protein Binding , Protein Kinase C/analysis , Protein Kinase C-alpha , Proteoglycans/biosynthesisABSTRACT
Two dynamin II-specific antibodies were used to detect dynamin II attached to highly purified Golgi membranes of HepG2 cells. Within the Golgi apparatus dynamin II is predominantly localized to the trans-Golgi network, as shown by immunoelectron microscopy. Increased binding of dynamin II to the trans-Golgi network in the presence of GTP-gamma-S and a reduced binding upon stimulation of secretion by phorbolester indicates that dynamin II may have a function in post-Golgi vesicle transport.