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Relationship between p-catenin expression and epithelial cell proliferation in gastric mucosa with intestinal metaplasia

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World Journal of Gastroenterology 2005年第28期11卷 4400-4403页

作者： adriana romiti Angelo Zullo Francesco Borrini Ida Sarcina Cesare Hassan Simon Winn Silverio Tomao Aldo Vecchione Sergio Morini Pietro Mingazzini Medical Oncology "Sant'Andrea" Hospital RomeItaly Gastroenterology and Digestive Endoscopy "Nuovo Regina Margherita" Hospital RomeItaly Department of Experimental Medicine and Pathology "La Sapienza" University RomeItaly Medical Oncology "Sant" Andrea" Hospital RomeItaly Oncology IRCCS "Regina Elena" RomeItaly Co-first-authors: Adriana Romiti and Angelo Zullo

AIM： To investigate β-catenin expression in patients with intestinal metaplasia, and to look for a possible relationship between β-catenin expression and either epithelial proliferation values or Helicobacter pylori （ H pylori） infection.METHODS： Twenty patients with complete type intestinal metaplasia were studied. β-Catenin expression and epithelial cell proliferation in antral mucosa were assessed using an immunohistochemical analysis. H pylori infection was detected by histology and a rapid urease test.RESULTS： Reduced β-catenin expression on the surface of metaplastic cells was detected in 13 （65%） out of 20 patients. Moreover, in eight （40%） patients intranuclear expression of β-catenin was found. When patients were analyzed according to H pylori infection, the prevalence of both β-catenin reduction at the cell surface and its intranuclear localization did not significantly differ between infected and uninfected patients. Cell proliferation was higher in patients with intranuclear β-catenin expression as compared to the remaining patients, although the difference failed to reach the statistical significance （36±8.9 vs 27.2±11.4, P= 0.06）. On the contrary, a similar cell proliferation value was observed between patients with reduced expression of β-catenin on cell surface and those with a normal expression （28.1±11.8 vs 26.1±8.8, P= 0.7）.H pylori infection significantly increased cell proliferation （33.3±10.2% vs 24.6±7.4% , respectively, P= 0.04）.CONCLUSION： Both cell surface reduction and intranuclear accumulation of β-catenin were detected in intestinal metaplasia. The intranuclear localization of β-catenin increases cell proliferation. H pylori infection does not seem to play a direct role in β-catenin alterations, whilst it significantly increases cell proliferation.

关键词： β-Catenin Intestinal metaplasia Proliferation Helicobacter pylori

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Follow-up of intestinal metaplasia in the stomach: When, how and why

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World Journal of Gastrointestinal Oncology 2012年第3期4卷 30-36页

作者： Angelo Zullo Cesare Hassan adriana romiti Michela Giusto Carmine Guerriero Roberto Lorenzetti Salvatore MA Campo Silverio Tomao Gastroenterology and Digestive Endoscopy Nuovo Regina Margherita Hospital Oncology Sant'Andrea Hospital Oncology Department of Experimental Medicine University of Rome "Sapienza"

Gastric cancer remains the second most frequent cause of cancer-related mortality in the world. Screening programs in some Asian countries are impractical in the majority of other countries worldwide. Therefore, follow-up of precancerous lesions is advisable for secondary gastric cancer prevention. Intestinal metaplasia (IM) is recognized as a precancerous lesion for gastric cancer, increasing the risk by 6-fold. IM is highly prevalent in the general population, being detected in nearly 1 of every 4 patients undergoing upper endoscopy. The IM prevalence rate is significantly higher in patients with Helicobacter pylori (H. pylori) infection, in first-degree relatives of gastric cancer patients, in smokers and it increases with patient age. IM is the "breaking point" in the gastric carcinogenesis cascade and does not appear to regress following H. pylori eradication, although the cure of infection may slow its progression. Gastric cancer risk is higher in patients with incomplete-type IM, in those with both antral and gastric body involvement, and the risk significantly increases with IM extension over 20% of the gastric mucosa. Scheduled endoscopic control could be cost-effective in IM patients, depending on the yearly incidence of gastric cancer in IM patients, the stage of gastric cancer at diagnosis discovered at surveillance, and the cost of endoscopy. As a pragmatic behavior, yearly endoscopic control would appear justified in all IM patients with at least one of these conditions: (1) IM extension > 20%; (2) the presence of incomplete type IM; (3) first-degree relative of gastric cancer patients; and (4) smokers. In the remaining IM patients, a less intensive (2-3 years) could be proposed.

关键词： Intestinal metaplasia Gastric cancer Follow-up Prevention Risk factors

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Tumors of ampulla of Vater: A case series and review of chemotherapy options

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World Journal of Gastrointestinal Oncology 2012年第3期4卷 60-67页

作者： adriana romiti Viola Barucca Angelo Zullo Ida Sarcina Roberta Di Rocco Chiara D'Antonio Marco Latorre Paolo Marchetti Oncology Unit University "La Sapienza" Sant'Andrea Hospital via di Grottarossa 1035 00189 Rome Italy Gastroenterology and Digestive Endoscopy "Nuovo Regina Margherita" Hospital via Morosini 30 00185 Rome Italy Department of General Surgery University "La Sapienza" Sant'Andrea Hospital via di Grottarossa 1035 00189 Rome Italy

Carcinomas of the Ampulla of Vater are rare tumors, accounting for 0.2% of gastrointestinal cancers. Compared with other biliary tract neoplasms, these tumors have a relatively favorable prognosis after surgical resection. Based on their epithelium of origin, two subtypes of ampullary carcinoma have been recently distinguished: intestinal and pancreatobiliary. This study evaluates histopathological features and outcomes of ampullary carcinoma and to compares the survival of these tumors to that of other biliary tract tumors. The chemotherapic options available for ampullary cancer are also reviewed. We analyzed data from 20 consecutive patients with ampullary carcinomas and 26 patients with other biliary tract carcinomas, observed in our Institution. Statistical analysis was performed by using either Fisher's exact test or χ2 test for categorical variables. Median time of survival was calculated and compared using the Log-Rank test. Similar distribution of demographic characteristics and stage between ampullary and other biliary tract cancers was observed. Patients with ampullary cancer underwent surgery more frequently than other biliary cancers while chemotherapy and radiotherapy were used equally. In accordance with the literature, a longer median survival was observed in the group of ampullary carcinomas.

关键词： Ampullary carcinoma Chemotherapy Radiotherapy Biliary tract cancer

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Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy

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World Journal of Gastrointestinal Oncology 2012年第2期4卷 22-25页

作者： Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi adriana romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici Viola Barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave Digestive and Liver Disease Unit Second Medical School"La Sapienza" UniversityS. An-drea Hospital00189 RomeItaly Nursery Science Second Medical School "La Sapienza" University00189 RomeItaly Radiology Unit "La Sapienza" University00189 RomeItaly Oncology Unit "La Sapienza" University00189 RomeItaly General Surgery Unit "La Sapienza" University00189 RomeItaly Digestive Endoscopy Unit Catholic University000192 RomeItaly Radiotheraphy Unit "La Sapienza" Uni-versity00189 RomeItaly

Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological *** include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous *** date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated *** hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct *** surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and *** was effective in decreasing the mass size and in resolving subsequent *** is also the f irst reported case of IPMN-B successfully treated with *** should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery.

关键词： Intraductal papillary neoplasm Bile duct Simultaneous Pancreatic intraductal papillary mucinous neoplasm

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Quality-Oriented Climate and Service Quality Among Healthcare Providers： Evidence From a Rehabilitation Center in Italy

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Chinese Business Review 2016年第9期15卷 424-436页

作者： Anna romiti Daria Sarti Chiara Lorini Leonardo Capecchi Martina Donzellini Guglielmo Bonaccorsi University of Florence Florence Italy

The importance of quality in service provision is widely recognized in health service research. However, a limited number of studies have investigated antecedents of quality in healthcare service provision. This article tries to shed further light on this under-researched field. Specifically, the aim of this study is to verify the relationship between the quality-oriented climate and service quality as perceived by employees. The study was conducted in a private non-profit Rehabilitation Centre in Italy using a questionnaire administered to all healthcare workers. The questions focused on perceptions of quality-oriented climate （priorization of quality care, social cooperation, and exchange）, four different connotations of the quality in healthcare provision （provision of high quality service, adequacy of time spent with patients, freedom in clinical decisions, and continuing relationships with patients）, as well as on respondents＇ background. Of the 248 healthcare workers, 183 completed the questionnaire. Hierarchical regression analysis was used to study the relationship between quality-oriented climate and outcome variables （quality in healthcare provision）. The results suggest that a quality-oriented climate does explain service quality in Healthcare settings： When an organization has implemented a quality-oriented climate, the service care provided by healtheare workers can determine an increase for three of the four investigated aspects of quality service provision （quality of care, freedom to make clinical decisions to meet patients＇ needs, and continuing relationships with patients）. The paper demonstrates that the offer of quality services involves in a different way the various healthcare professionals and/or management staff. This research provides interesting findings for healthcare manager in Health Service settings regarding the management of a quality-oriented process of service provision.

关键词： service climate service quality healthcare providers rehabilitation center prioritization of care cooperation

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意大利混合式防波堤的经验

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港工技术 1988年第Z1期 118-125页

作者： G.romiti A.NOLI L.FRANCO 杨曼蓉

本文回顾了意大利混合式防波堤的丰富经验,对使人感兴趣的工程及其破坏情况进行了描述。对两项计划修建的重要工程以及为该设计进行的大量试验也进行了论述。模型试验显示了不规则波的影响、胸墙的形状对越浪及波浪撞击的影响、冲刷对... 详细信息

本文回顾了意大利混合式防波堤的丰富经验,对使人感兴趣的工程及其破坏情况进行了描述。对两项计划修建的重要工程以及为该设计进行的大量试验也进行了论述。模型试验显示了不规则波的影响、胸墙的形状对越浪及波浪撞击的影响、冲刷对护脚块体稳定性的影响并对方形沉箱及园形沉箱的性能进行了比较。

关键词：防波堤阻浪堤海上构筑物沉箱深基础胸墙设计波高波浪热那亚布林迪西四脚锥体奇维塔韦基亚护脚石堤抛石基床直立式浮托力意大利南欧

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