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Hepatocellular carcinoma in cirrhotic patients with portal hypertension:Is liver resection always contraindicated?

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World Journal of Gastroenterology 2011年第46期17卷 5083-5088页

作者： Andrea Ruzzenente Alessandro Valdegamberi Tommaso Campagnaro Simone Conci Silvia Pachera Calogero Iacono alfredo Guglielmi department of Surgery Division of General Surgery"A"GB Rossi HospitalUniversity of Verona

AIM:To analyze the outcome of hepatocellular car-cinoma(HCC)resection in cirrhosis patients,related to presence of portal hypertension(PH)and extent of ***:A retrospective analysis of 135 patients with HCC on a background of cirrhosis was submitted to curative liver ***:PH was present in 44(32.5%)*** mortality and morbidity were 2.2% and 33.7%,*** survival time in patients with or without PH was 31.6 and 65.1 mo,respectively(P=0.047);in the subgroup with Child-Pugh class A cirrhosis,median survival was 65.1 mo and 60.5 mo,respectively(P=0.257).Survival for patients submitted to limited liver resection was not significantly different in presence or absence of ***,median survival for patients after resection of 2 or more segments with or without PH was 64.4 mo and 163.9 mo,respectively(P=0.035).CONCLUSION:PH is not an absolute contraindication to liver resection in Child-Pugh class A cirrhotic patients,but resection of 2 or more segments should not be recommended in patients with PH.

关键词：肝硬化肝切除患者肝癌禁忌高压平均存活时间 PH值

Evaluation of a Therapeutic Alternative for Telogen Effluvium: A Pilot Study

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Journal of Cosmetics, dermatological Sciences and Applications 2013年第3期3卷 9-16页

作者： alfredo rossi Lara Priolo Alessandra Iorio Enrica Vescarelli Martina Gerardi Daniele Campo Donato Di Nunno Simona Ceccarelli Stefano Calvieri Antonio Angeloni Cinzia Marchese department of Experimental Medicine Sapienza University of Rome Rome Italy department of Internal Medicine and Medical Specialties Sapienza University of Rome Rome Italy department of Molecular Medicine Sapienza University of Rome Rome Italy. Italian Orthodermic Institute Rome Italy

Background/Aim: Telogen effluvium (TE) is a scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase. Nigella sativa (NS) is a dicotyledonous belonging to the Ranunculacae family. It has been shown that its major constituent, tymoquinon (TQ), exerts anti-oxidant and anti-inflammatory effects by inhibiting pro-inflammatory mediators, such as cyclooxygenase and prostaglandin D2. The aim of this study is to evaluate the efficacy of NS essential oil as a potential treatment for TE, a pathology characterized by a significant inflammatory component. Study design/Methods: Twenty patients affected by TE for this double-blind, placebo controlled and randomized study were enrolled. Ten of these patients were treated with a scalp lotion containing 0.5% NS, daily for 3 months, while the other ten patients were treated with placebo daily for 3 months. Videodermatoscopic analysis (Trichoscan dermoscope Fotofinder?) and evaluation of three independent dermatologists were performed before treatment (T0), after 3 months of treatment (T3) and at the 6 months follow-up (T6). Results: The results showed a significant improvement in 70% of patients treated with NS. Videodermatoscopic analysis showed a significant increment of hair density and hair thickness in patients treated with NS. NS was also able to reduce the inflammation observed in the majority of patients affected by TE. Conclusions: The results of this study suggest that NS can be considered potentially useful for the treatment of TE.

关键词： Telogen Effluvium Nigella sativa Hair density Hair Thickness

Central pancreatectomy: The Dagradi Serio Iacono operation. Evolution of a surgical technique from the pioneers to the robotic approach

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World Journal of Gastroenterology 2014年第42期20卷 15674-15681页

作者： Calogero Iacono Andrea Ruzzenente Luca Bortolasi alfredo Guglielmi department of Surgery Division of General Surgery "A" Unit of Hepato-Biliary-Pancreatic Surgery University of Verona Medical School "GB Rossi" University Hospital

Central pancreatectomy(CP) is a parenchyma-sparing surgical procedure. The aims are to clarify the history and the development of CP and to give credits to those from whom it came. Ehrhardt, in 1908, described segmental neck resection(SNR) followed, in 1910, by Finney without reconstructive part. In 1950 Honjyo described two cases of SNR combined with gastrectomy for gastric cancer infiltrating the neck of the pancreas. Guillemin and Bessot(1957) and Letton and Wilson(1959) dealt only with the reconstructive aspect of CP. Dagradi and Serio, in 1982, performed the first CP including the resective and reconstructive aspects. Subsequently Iacono has validated it with functional endocrine and exocrine tests and popularized it worldwide. In 2003, Baca and Bokan performed laparoscopic CP and, In 2004, Giulianotti et al performed a robotic assisted CP. CP is performed worldwide either by open surgery or by using minimally-invasive or robotic approaches. This confirms that the operation does not belong to whom introduced it but to everyone who carries out it; however credit must be given to those from whom it came.

关键词： Pancreatic history Pancreatic surgery Cen-tral pan

Prognostication and response assessment in liver and pancreatic tumors:The new imaging

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World Journal of Gastroenterology 2015年第22期21卷 6794-6808页

作者： Riccardo de Robertis Paolo Tinazzi Martini Emanuele demozzi Gino Puntel Silvia Ortolani Sara Cingarlini Andrea Ruzzenente alfredo Guglielmi Giampaolo Tortora Claudio Bassi Paolo Pederzoli Mirko D'Onofrio department of Radiology Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona department of Radiology Casa di Cura Pederzoli department of Oncology Verona Comprehensive Cancer Network G.B.Rossi Hospital University of Verona department of Hepato-Biliary Surgery Verona Comprehensive Cancer NetworkG.B. Rossi Hospital University of Verona department of Pancreatic Surgery Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona department of Pancreatic Surgery Casa di Cura Pederzoli

Diffusion-weighted imaging(DWI), dynamic contrastenhanced magnetic resonance imaging(DCE-MRI) and perfusion computed tomography(CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT ***, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography(PET)CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging,therefore these techniques could be used also for posttreatment assessment, even at an early stage. The aim of this editorial is to describe possible applications of new functional imaging techniques apart frommolecular imaging to hepatic and pancreatic tumors through a review of up-to-date literature data, with a particular emphasis on pathological correlations,prognostic stratification and post-treatment monitoring.

关键词： Diffusion magnetic resonance imaging Perfusion imaging Hepatocellular carcinoma Liverneoplasms Pancreatic neoplasms

Altered molecular pattern of mucosal healing in Crohn's disease fibrotic stenosis

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World Journal of Gastrointestinal Pathophysiology 2013年第3期4卷 53-58页

作者： Enzo Ierardi Floriana Giorgio Domenico Piscitelli Mariabeatrice Principi Santina Cantatore Maria Grazia Fiore Roberta rossi Michele Barone alfredo Di Leo Carmine Panella Gastroenterology Department of Medical and Surgical Sciences University of Foggia 71100 Foggia Italy Gastroenterology Department of Emergency and Organ Transplantation University of Bari 70124 Bari Italy

AIM: To investigate tumor necrosis factor-α (TNF-α), syndecan 1 and basic fibroblast growth factor (bFGF) balance in Crohn's disease (CD) strictures. METHODS: Our study was performed on 24 surgical specimens of CD fibrotic stenosis. Ten histological normal surgical samples were retrieved for both the large and small bowel from patients with benign conditions and healthy tissue represented control collection. Sex and age in controls did not differ from CD group. Three endoscopic biopsy specimens taken after informed consent in subjects with normal colon were also used as negative controls. TNF-α, syndecan 1 and bFGF were detected by both reverse transcriptase reverse transcriptase polymerase chain reaction after mRNA extraction (results expressed as fold-change) and ***: TNF-α did not show any significant difference between CD and control specimens (1.54 ± 1.19; P > 0.05). Very high levels of bFGF were observed in CD (11.76 ± 4.65; P decan 1 which showed a moderate increase (5.53 ± 2.18; P dent-NeumannKeuls showed: bFGF > syndecan 1 > TNF-α = control. Immunoreactivity for bFGF was observed in epithelial, stromal, endothelial cells and even in the muscular layer, whilst in normal tissue it was almost unexpressed. Syndecan 1 and TNF-α staining was confined to mucosal epithelial and stromal cells, while in controls syndecan 1 was found in its normal site, i.e. , basolateral area of the crypts and TNF-α very poorly expressed. CONCLUSION: Fibrotic stenosis of CD may be the final result of an irreversible transformation of different cells into fibrogenic phenotype no longer inhibited by posttranscriptional regulation.

关键词： Crohn’s disease Fibrotic stenosis Tumor necrosis factor-α Syndecan 1 Basic fibroblast growth factor