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1The role of gut microbiota(commensal bacteria)and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer:contribution of germ-free and gnotobiotic animal models of human diseases显示文摘Metagenomic approaches are currently being used to decipher the genome of the microbiota(microbiome),and,in parallel,functional studies are being performed to analyze the effects of the microbiota on the host.Gnotobiological methods are an indispensable tool for studying the consequences of bacterial colonization.Animals used as models of human diseases can be maintained in sterile conditions(isolators used for germ-free rearing)and specifically colonized with defined microbes(including non-cultivable commensal bacteria).The effects of the germ-free state or the effects of colonization on disease initiation and maintenance can be observed in these models.Using this approach we demonstrated direct involvement of components of the microbiota in chronic intestinal inflammation and development of colonic neoplasia(i.e.,using models of human inflammatory bowel disease and colorectal carcinoma).In contrast,a protective effect of microbiota colonization was demonstrated for the development of autoimmune diabetes in non-obese diabetic(NOD)mice.Interestingly,the development of atherosclerosis in germ-free apolipoprotein E(ApoE)-deficient mice fed by a standard low-cholesterol diet is accelerated compared with conventionally reared animals.Mucosal induction of tolerance to allergen Bet v1 was not influenced by the presence or absence of microbiota.Identification of components of the microbiota and elucidation of the molecular mechanisms of their action in inducing pathological changes or exerting beneficial,disease-protective activities could aid in our ability to influence the composition of the microbiota and to find bacterial strains and components(e.g.,probiotics and prebiotics)whose administration may aid in disease prevention and treatment.Helena Tlaskalova-Hogenova Renata Stepankova Hana Kozakova Tomas Hudcovic Luca Vannucci Ludmila Tuckova Pavel Rossmann TomasHrncır Miloslav Kverka Zuzana Zakostelska Klara Klimesova Jaroslava Pribylova Jirina Bartova Daniel Sanchez Petra Fundova Dana Borovska Dagmar Sru˚tkova Zdenek Zıdek Martin Schwarzer Pavel Drastich David P Funda 2011Cellular & Molecular Immunology2011,8,2:47
2Steps to consider in the approach and management of critically ill patient with spontaneous intracerebral hemorrhage显示文摘Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurologicalneurosurgical emergency. Time is brain so that action should be taken fast and accurately. The most significant prognostic factors are level of consciousness, location, volume and ventricular extension of the bleeding. Nihilism and early withdrawal of active therapy undoubtedly influence the final result. Although there are no proven therapeutic measures, treatment should be individualized and guided preferably by pathophysiology. The multidisciplinary teamwork is essential. Results of recently completed studies have birth to promising new strategies. For correct management it's important to establish an orderly and systematic strategy based on clinical stabilization, evaluation and establishment of prognosis, avoiding secondary insults and adoption of specific individualized therapies, including hemostatic therapy and intensive control of elevated blood pressure. Uncertainty continues regarding the role of surgery.Daniel Agustin Godoy Gustavo Rene Pi?ero Patricia Koller Luca Masotti Mario Di Napoli 2015World Journal of Critical Care Medicine2015,4,3:14
3Multimodal treatment of gastric cancer in the west: Where are we going?显示文摘The incidence of gastric cancer(GC) is decreasing worldwide,especially for intestinal histotype of the distal third of the stomach.On the contrary,proximal location and diffuse Lauren histotype have been reported to be generally stable over time.In the west,no clear improvement in long-term results was observed in clinical and population-based studies.Results of treatment in these neoplasms are strictly dependent on tumor stage.Adequate surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however,results are still unsatisfactory for advanced stages(Ⅲ and Ⅳ),for which additional treatments could provide a survival benefit.This implies a tailored approach to GC.The aim of this review was to summarize the main multimodal treatment options in advanced resectable GC.Perioperative or postoperative treatments,including chemotherapy,chemoradiotherapy,targeted therapies,and hyperthermic intraperitoneal chemotherapy have been reviewed,and the main ongoing and completed trials have been analyzed.An original tailored multimodal approach to non-cardia GC has been also proposed.Daniele Marrelli Karol Polom Giovanni de Manzoni Paolo Morgagni Gian Luca Baiocchi Franco Roviello 2015World Journal of Gastroenterology2015,21,26:14
4The enhanced X-ray Timing and Polarimetry mission—eXTP显示文摘In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The mission aims at determining the equation of state of matter at supra-nuclear density, measuring effects of QED, and understanding the dynamics of matter in strong-field gravity. In addition to investigating fundamental physics, eXTP will be a very powerful observatory for astrophysics that will provide observations of unprecedented quality on a variety of galactic and extragalactic objects. In particular, its wide field monitoring capabilities will be highly instrumental to detect the electro-magnetic counterparts of gravitational wave sources.The paper provides a detailed description of:(1) the technological and technical aspects, and the expected performance of the instruments of the scientific payload;(2) the elements and functions of the mission, from the spacecraft to the ground segment.ShuangNan Zhang Andrea Santangelo Marco Feroci YuPeng Xu FangJun Lu Yong Chen Hua Feng Shu Zhang Sφren Brandt Margarita Hernanz Luca Baldini Enrico Bozzo Riccardo Campana Alessandra De Rosa YongWei Dong Yuri Evangelista Vladimir Karas Norbert Meidinger Aline Meuris Kirpal Nandra Teng Pan Giovanni Pareschi Piotr Orleanski QiuShi Huang Stephane Schanne Giorgia Sironi Daniele Spiga Jiri Svoboda Gianpiero Tagliaferri Christoph Tenzer Andrea Vacchi Silvia Zane Dave Walton ZhanShan Wang Berend Winter Xin Wu Jean J.M.in't Zand Mahdi Ahangarianabhari Giovanni Ambrosi Filippo Ambrosino Marco Barbera Stefano Basso Jörg Bayer Ronaldo Bellazzini Pierluigi Bellutti Bruna Bertucci Giuseppe Bertuccio Giacomo Borghi XueLei Cao Franck Cadoux Francesco Ceraudo TianXiang Chen Yu Peng Chen Jerome Chevenez Marta Civitani Wei Cui WeiWei Cui Thomas Dauser Ettore Del Monte Sergio Di Cosimo Sebastian Diebold Victor Doroshenko Michal Dovciak YuanYuan Du Lorenzo Ducci QingMei Fan Yannick Favre Fabio Fuschino JoséLuis Ga'lvez Min Gao MingYu Ge Olivier Gevin Marco Grassi QuanYing Gu YuDong Gu DaWei Han Bin Hong Wei Hu Long Ji ShuMei Jia WeiChun Jiang Thomas Kennedy Ingo Kreykenbohm Irfan Kuvvetli Claudio Labanti Luca Latronico Gang Li MaoShun Li Xian Li Wei Li ZhengWei Li Olivier Limousin HongWei Liu XiaoJing Liu Bo Lu Tao Luo Daniele Macera Piero Malcovati Adrian Martindale Malgorzata Michalska Bin Meng Massimo Minuti Alfredo Morbidini Fabio Muleri Stephane Paltani Emanuele Perinati Antonino Picciotto Claudio Piemonte JinLu Qu Alexandre Rachevski Irina Rashevskaya Jerome Rodriguez Thomas Schanz ZhengXiang Shen LiZhi Sheng JiangBo Song LiMing Song Carmelo Sgro Liang Sun Ying Tan Phil Uttley Bo Wang DianLong Wang GuoFeng Wang Juan Wang LangPing Wang YuSa Wang Anna L.Watts XiangYang Wen Jörn Wilms ShaoLin Xiong JiaWei Yang Sheng Yang YanJi Yang Nian Yu WenDa Zhang Gianluigi Zampa Nicola Zampa Andrzej A.Zdziarski AiMei Zhang ChengMo Zhang Fan Zhang Long Zhang Tong Zhang Yi Zhang XiaoLi Zhang ZiLiang Zhang BaoSheng Zhao ShiJie Zheng Yu Peng Zhou Nicola Zorzi J.Frans Zwart 2019Science China(Physics,Mechanics & Astronomy)2019,62,2:11
5An integrated approach for increasing breeding efficiency in apple and peach in Europe显示文摘Despite the availability of whole genome sequences of apple and peach,there has been a considerable gap between genomics and breeding.To bridge the gap,the European Union funded the FruitBreedomics project(March 2011 to August 2015)involving 28 research institutes and private companies.Three complementary approaches were pursued:(i)tool and software development,(ii)deciphering genetic control of main horticultural traits taking into account allelic diversity and(iii)developing plant materials,tools and methodologies for breeders.Decisive breakthroughs were made including the making available of ready-to-go DNA diagnostic tests for Marker Assisted Breeding,development of new,dense SNP arrays in apple and peach,new phenotypic methods for some complex traits,software for gene/QTL discovery on breeding germplasm via Pedigree Based Analysis(PBA).This resulted in the discovery of highly predictive molecular markers for traits of horticultural interest via PBA and via Genome Wide Association Studies(GWAS)on several European genebank collections.FruitBreedomics also developed pre-breeding plant materials in which multiple sources of resistance were pyramided and software that can support breeders in their selection activities.Through FruitBreedomics,significant progresses were made in the field of apple and peach breeding,genetics,genomics and bioinformatics of which advantage will be made by breeders,germplasm curators and scientists.A major part of the data collected during the project has been stored in the FruitBreedomics database and has been made available to the public.This review covers the scientific discoveries made in this major endeavour,and perspective in the apple and peach breeding and genomics in Europe and beyond.Francois Laurens Maria JoséAranzana Pere Arus Daniele Bassi Marco Bink Joan Bonany Andrea Caprera Luca Corelli-Grappadelli Evelyne Costes Charles-Eric Durel Jehan-Baptiste Mauroux Hélène Muranty Nelson Nazzicari Thierry Pascal Andrea Patocchi Andreas Peil Bénédicte Quilot-Turion Laura Rossini Alessandra Stella Michela Troggio Riccardo Velasco Eric van de Weg 2018Horticulture Research2018,5,1:10
6Esophagogastric junction gastrointestinal stromal tumor:Resection vs enucleation显示文摘Esophageal gastrointestinal stromal tumors(GISTs) are extremely uncommon,representing approximately 5% of GISTs with the majority of esophageal GISTs occurring at the esophagogastric junction(EGJ).The treatment options available for these GISTs are fairly controversial.Many different options are nowadays at our disposal.From surgery to the target therapies we have the possibility to treat the majority of GISTs,including those which are defined as unresectable.The EGJ GISTs represent a stimulating challenge for the surgeon.The anatomical location increases the possibility of postoperative complications.As the role of negative margins in GIST surgery is still controversial and the eff icacy of target therapy has been demonstrated,why not treat EGJ GISTs with enucleation and,where indicated,adjuvant target therapy?Federico Coccolini Fausto Catena Luca Ansaloni Daniel Lazzareschi Antonio Daniele Pinna 2010World Journal of Gastroenterology2010,16,35:7
7Peliosis hepatis: Personal experience and literature review显示文摘Peliosis hepatis(PH) is a disease characterized by multiple and small,blood-filled cysts within the parenchymatous organs. PH is a very rare disease,more common in adults,and when it affects the liver,it comes to the surgeon's attention only in an extremely urgent situation after the lesion's rupture with the resulting hemoperitoneum. This report describes the case of a 29-year-old woman affected by recurring abdominal pain. Computed tomography scans showed a hepatic lesion formed by multiple hypodense areas,which showed an early acquisition of the contrast during the arterial phase. Furthermore,it remained isodense with the remaining parenchyma during the late venous phase. We decided on performing a liver resection of segment Ⅶ while avoiding a biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal PH. PH should always be considered in the differential diagnosis of hepatic lesions. Clinicians should discuss the possible causes and issues related to the differential diagnosis in addition to the appropriate therapeutic approach. The fortuitous finding of a lesion,potentially compatible with PH,requires elective surgery with diagnostic and therapeutic intents. The main aim is to prevent the risk of a sudden bleeding that,in absence of properly equipped structures,may have a fatal outcome.Daniele Crocetti Andrea Palmieri Giuseppe Pedullà Vittorio Pasta Valerio D'Orazi Gian Luca Grazi 2015World Journal of Gastroenterology2015,21,46:7
8Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries.Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho 2017World Journal of Hepatology2017,9,8:7
9Prophylaxis for venous thromboembolism after resection of hepatocellular carcinoma on cirrhosis: Is it necessary?显示文摘AIM: To assess the safety and effectiveness of prophylaxis for venous thromboembolism (VTE) in a large population of patients with hepatocellular carcinoma (HCC) on cirrhosis.METHODS: Two hundred and twenty nine consecutive cirrhotic patients with HCC who underwent hepatic resection were retrospectively evaluated to assess whether there was any difference in the incidence of thrombotic or hemorrhagic complications between those who received and those who did not receive prophylaxis with low-molecular weight heparin.Differences and possible effects of the following parameters were investigated: age,sex,Child-Pugh and model for end-stage liver disease (MELD) score,platelet count,presence of esophageal varices,type of hepatic resection,duration of surgery,intraoperative transfusion of blood and fresh frozen plasma (FFP),body mass index,diabetes and previous cardiovascular disease.RESULTS: One hundred and fifty seven of 229 (68.5%) patients received antithromboembolic prophylaxis (group A) while the remaining 72 (31.5%) patients did not (group B).Patients in group B had higher Child-Pugh and MELD scores,lower platelet counts,a higher prevalence of esophageal varices and higher requirements for intraoperative transfusion of FFP.The incidence of VTE and postoperative hemorrhage was 0.63% and 3.18% in group A and 1.38% and 1.38% in group B,respectively;these differences were not significant.None of the variables analyzed including prophylaxis proved to be risk factors for VTE,and only the presence of esophageal varices was associated with an increased risk of bleeding.CONCLUSION: Prophylaxis is safe in cirrhotic patients without esophageal varices;the real need for prophylaxis should be better assessed.Marco Vivarelli Matteo Zanello Chiara Zanfi Alessandro Cucchetti Matteo Ravaioli Massimo Del Gaudio Matteo Cescon Augusto Lauro Eva Montanari Gian Luca Grazi Antonio Daniele Pinna 2010World Journal of Gastroenterology2010,16,17:6
10Is Portal Hypertension a Contraindication to Hepatic Resection?显示文摘Alessandro Cucchetti Giorgio Ercolani Marco Vivarelli Matteo Cescon Matteo Ravaioli Giovanni Ramacciato Gian Luca Grazi Antonio Daniele Pinna 2009Annals of Surgery2009,,6:5
11The crossroads of receptor-mediated signaling and endocytosis in plants显示文摘Plants deploy numerous plasma membrane receptors to sense and rapidly react to environmental changes. Correct localization and adequate protein levels of the cell-surface receptors are critical for signaling activation and modulation of plant development and defense against pathogens. After ligand binding, receptors are internalized for degradation and signaling attenuation. However, one emerging notion is that the ligand-induced endocytosis of receptor complexes is important for the signal duration, ampli tude, and specificity. Recently, mutants of major endocytosis players, including clathrin and dynamin have been shown to display defects in activation of a subset of signal transduction pathways, implying that signaling in plants might not be solely restricted to the plasma membrane. Here, we summarize the up-to-date knowledge of receptor complex endocytosis and its effect on the signaling outcome, in the context of plant development and immunity.Lucas Alves Neubus Claus Daniel V.Savatin Eugenia Russinova 2018Journal of Integrative Plant Biology2018,60,9:5
12Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria显示文摘BACKGROUND Surgical resection and radiofrequency ablation(RFA)represent two possible strategy in treatment of hepatocellular carcinoma(HCC)in Milan criteria.AIM To evaluate short-and long-term outcome in elderly patients(>70 years)with HCC in Milan criteria,which underwent liver resection(LR)or RFA.METHODS The study included 594 patients with HCC in Milan criteria(429 in LR group and 165 in RFA group)managed in 10 European centers.Statistical analysis was performed using the Kaplan-Meier method before and after propensity score matching(PSM)and Cox regression.RESULTS After PSM,we compared 136 patients in the LR group with 136 patients in the RFA group.Overall survival at 1,3,and 5 years was 91%,80%,and 76%in the LR group and 97%,67%,and 41%in the RFA group respectively(P=0.001).Diseasefree survival at 1,3,and 5 years was 84%,60%and 44%for the LR group,and 63%,36%,and 25%for the RFA group(P=0.001).Postoperative Clavien-Dindo IIIIV complications were lower in the RFA group(1%vs 11%,P=0.001)in association with a shorter length of stay(2 d vs 7 d,P=0.001).In multivariate analysis,Model for End-stage Liver Disease(MELD)score(>10)[odds ratio(OR)=1.89],increased value of international normalized ratio(>1.3)(OR=1.60),treatment with radiofrequency(OR=1.46),and multiple nodules(OR=1.19)were independent predictors of a poor overall survival while a high MELD score(>10)(OR=1.51)and radiofrequency(OR=1.37)were independent factors associated with a higher recurrence rate.CONCLUSION Despite a longer length of stay and a higher rate of severe postoperative complications,surgery provided better results in long-term oncological outcomes as compared to ablation in elderly patients(>70 years)with HCC in Milan criteria.Maria Conticchio Riccardo Inchingolo Antonella Delvecchio Letizia Laera Francesca Ratti Maximiliano Gelli Ferdinando Anelli Alexis Laurent Giulio Vitali Paolo Magistri Giacomo Assirati Emanuele Felli Taiga Wakabayashi Patrick Pessaux Tullio Piardi Fabrizio di Benedetto Nicola de'Angelis Javier Briceño AntonioRampoldi RenèAdam Daniel Cherqui Luca Antonio Aldrighetti Riccardo Memeo 2021World Journal of Gastroenterology2021,27,18:4
13Follow-up after gastrectomy for cancer:results of an international web round table显示文摘Oncological follow-up after radical gastrectomy for cancer still represents a discrepancy in the field,with many retrospective series demonstrating that early diagnosis of recurrence does not result in an improvement in patient survival;yet,many centers with high quality of care still provide routine patient follow-up after surgery by clinical and instrumental controls.This was the topic for a web round table entitled'Rationale and limits of oncological follow-up after gastrectomy for cancer'that was launched one year before the 10th International Gastric Cancer Congress.Authors having specific expertise were invited to comment on their previous publications to provide the subject for an open debate.During a three-month-long discussion,32 authors from 12 countries participated,and 2299people visited the dedicated web page.Substantial differences emerged between the participants:authors from Japan,South Korea,Italy,Brazil,Germany and France currently engage in instrumental follow-up,whereas authors from Eastern Europe,Peru and India do not,and British and American surgeons practice it in a rather limited manner or in the context of experimental studies.Although endoscopy is still considered useful by most authors,all the authors recognized that computed tomography scanning is the method of choice to detect recurrence;however,many limit follow-up to clinical and biochemical examinations,and acknowledge the lack of improved survival with early detection.Gian Luca Baiocchi Yasuhiro Kodera Daniele Marrelli Fabio Pacelli Paolo Morgagni Franco Roviello Giovanni De Manzoni 2014World Journal of Gastroenterology2014,20,34:4
14Prognostic Value of the 7th AJCC/UICC TNM Classification of Noncardia Gastric Cancer: Analysis of a Large Series From Specialized Western Centers显示文摘Daniele Marrelli Paolo Morgagni Giovanni de Manzoni Arianna Coniglio Alberto Marchet Luca Saragoni Guido Tiberio Franco Roviello 2012Annals of Surgery2012,,3:3
15Incidence and treatment of mediastinal leakage after esophagectomy:Insights from the multicenter study on mediastinal leaks显示文摘BACKGROUND Mediastinal leakage(ML) is one of the most feared complications of esophagectomy. A standard strategy for its diagnosis and treatment has beendifficult to establish because of the great variability in their incidence and mortality rates reported in the existing series.AIM To assess the incidence, predictive factors, treatment, and associated mortality rate of mediastinal leakage using the standardized definition of mediastinal leaks recently proposed by the Esophagectomy Complications Consensus Group(ECCG).METHODS Seven Italian surgical centers(five high-volume, two low-volume) affiliated with the Italian Society for the Study of Esophageal Diseases designed and implemented a retrospective study including all esophagectomies(n = 501) with intrathoracic esophagogastric anastomosis performed from 2014 to 2017.Anastomotic MLs were defined according to the classification recently proposed by the ECCG.RESULTS Fifty-nine cases of ML were recorded, yielding an overall incidence of 11.8%(95%CI: 9.1%-14.9%). The surgical approach significantly influenced the occurrence of ML: the proportion of leakage was 10.5% and 9% after open and hybrid esophagectomy(HE), respectively, and doubled(20%) after totally minimally invasive esophagectomy(TMIE)(P = 0.016). No other predictive factors were found. The 30-and 90-d overall mortality rates were 1.4% and 3.2%,respectively; the 30-and 90-d leak-related mortality rates were 5.1% and 10.2%,respectively; the 90-d mortality rates for TMIE and HE were 5.9% and 1.8%,respectively. Endoscopy was the first-line treatment in 49% of ML cases, with the need for retreatment in 17.2% of cases. Surgery was needed in 44.1% of ML cases.Endoscopic treatment had the lowest mortality rate(6.9%). Removal of the gastric tube with stoma formation was necessary in 8(13.6%) cases.CONCLUSION The incidence of ML after esophagectomy was high mainly in the TMIE group.However, the general and specific(leak-related) mortality rates were low. Early treatment(surgical or endoscopic) of severe leaks is mandatory to limit related mortality.Uberto Fumagalli Gian Luca Baiocchi ANDrea Celotti Paolo Parise ANDrea Cossu Luigi Bonavina Daniele Bernardi Giovanni de Manzoni Jacopo Weindelmayer Giuseppe Verlato Stefano Santi Giovanni Pallabazzer Nazario Portolani Maurizio Degiuli Rossella Reddavid Stefano de Pascale 2019World Journal of Gastroenterology2019,25,3:3
16Surgical treatment of synchronous colorectal liver and lung metastases: the usefulness of thoracophrenolaparotomy for single stage resection显示文摘When suitable, surgery still remains the therapeutic option to be preferred for patients carrier of colorectal liver and lung metastases. Since thoracophrenolaparotomy should be helpful during liver resection for some of these patients, simultaneous removal of right lung metastases can be proposed through this approach. Eleven consecutive patients(median age of 53 years) carrier of colorectal liver and lung metastases, underwent single session surgical resection of both liver and right lung lesions by means of J-shaped thoracophrenolaparotomy. The median number of liver metastases removed was 5(range 2-30) and of lung metastases removed was 2(range 1-3). Lung metastases were located in the upper lobe in 1 patient, in the middle lobe in 2, in the lower lobe in 6, and in the upper and lower lobe in 2. Mortality and major morbidity were nil. Two patients had a minor morbidity: one had wound infection and bile leakage treated conservatively and the other had transient fever. Mean overall survival was 24.4 months. An aggressive surgical approach should be undertaken for colorectal metastases: in case of multifocal liver disease with complex presentations, J-shaped thoracophrenolaparotomy could be considered as safe approach for combined liver and right lung metastasectomies.Daniele Del Fabbro Marco Alloisio Fabio Procopio Matteo Cimino Matteo Donadon Angela Palmisano Luca Viganò Guido Torzilli 2016Hepatobiliary & Pancreatic Diseases International2016,15,2:3
17Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series显示文摘AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for recurrence.CONCLUSION The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up.Gian Luca Baiocchi Sarah Molfino Carla Baronchelli Simone Giacopuzzi Daniele Marrelli Paolo Morgagni Maria Bencivenga Luca Saragoni Carla Vindigni Nazario Portolani Maristella Botticini Giovanni De Manzoni 2017World Journal of Gastroenterology2017,23,45:3
18Impact of immunosuppression minimization and withdrawal in long-term hepatitis C virus liver transplant recipients显示文摘AIM:To investigate the effects of different immunosuppressive regimens and avoidance on fibrosis progression in hepatitis C virus(HCV)liver transplant(LT)recipients.METHODS:We retrospectively compared the liver biopsies of well-matched HCV LT recipients under calcineurin inhibitors(CNI group,n=21)and mycophenolate(MMF group,n=15)monotherapy,with those patients who successfully withdrawn immunosuppression(IS)therapy from at least 3 years(TOL group,n=10).To perform the well-matched analysis,all HCV transplanted patients from December 1993 were screened.Only those HCV patients who reached the following criteria were considered for the analysis:(1)at least3 years of post-operative follow-up;(2)patients with normal liver graft function under low dose CNI monotherapy(CNI group);(3)patients with normal liver graft function under antimetabolite(Micophenolate Mofetil or coated mycophenolate sodium)monotherapy(MMF group);and(4)recipients with normal liver function without any IS.We excluded from the analysis recipients who were IS free or under monotherapy for<36 mo,recipients with cirrhosis or with unstable liver function tests.RESULTS:Thirty six recipients were enrolled in the study.Demographics,clinical data,time after LT and baseline liver biopsies were comparable in the three groups.After six years of follow-up,there was no worsening of hepatic fibrosis in the MMF group(2.5±1.5Ishak Units vs 2.9±1.7 Ishak Units,P=0.5)and TOL group(2.7±10.7 vs 2.5±1.2,P=0.2).In contrast,a significant increase in the fibrosis score was observed in the CNI group(2.2±1.7 vs 3.9±1.6,P=0.008).The yearly fibrosis progression rate was significantly worse in the CNI group(0.32±0.35)vs MMF group(0.03±0.31,P=0.03),and TOL group(-0.02±0.27,P=0.02).No differences have been reported in grading scores for CNI group(2.79±1.9,P=0.7),MMF group(3.2±1.5,P=0.9)and TOL group(3.1±1.4,P=0.2).Twenty four patients were treated with low dose ribavirin(8TOL,7 MMF,9 CNI).The hepatitis C titers were comparable in the three groups.No episodes of rejection have been reported despite differences of liver function test in the three groups during the observational period.CONCLUSION:IS withdrawal and MMF monotherapy is safe and seems to be associated with the slowest fibrosis progression in HCV LT recipients.Tommaso Maria Manzia Roberta Angelico Paolo Ciano Jon Mugweru Kofi Owusu Daniele Sforza Luca Toti Giuseppe Tisone 2014World Journal of Gastroenterology2014,20,34:3
19Liver transplantation from hepatitis B surface antigen positive donors: A safe way to expand the donor pool显示文摘Elisabetta Loggi Lorenzo Micco Giorgio Ercolani Alessandro Cucchetti Florian K. Bihl Gian Luca Grazi Stefano Gitto Andrea Bontadini Mauro Bernardi Paolo Grossi Alessandro Nanni Costa Antonio Daniele Pinna Christian Brander Pietro Andreone 2011Journal of Hepatology2011,,3:2
20Gastrointestinal stromal tumor and mitosis,pay attention显示文摘The difference between stages Ⅰ and Ⅲ of gastric gastrointestinal stromal tumor depends principally on the number of mitosis.According with TNM classification,the presence in the tumor of high mitotic rate determines the upgrading.Many studies exposed different count techniques in evaluating the number of mitosis.An international standardized method to assess mitotic rate is needed.Federico Coccolini Fausto Catena Luca Ansaloni Antonio Daniele Pinna 2012World Journal of Gastroenterology2012,18,6:2
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