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Pediatric T-tube in adult liver transplantation:Technical refinements of insertion and removal

World Journal of Gastrointestinal Surgery 2021年第12期13卷 1628-1637页

作者： Gabriele Spoletini Giuseppe Bianco Antonio Franco francesco Frongillo Erida Nure francesco Giovinazzo Federica Galiandro andrea Tringali Vincenzo Perri Guido Costamagna Alfonso Wolfango Avolio Salvatore Agnes General Surgery and Liver Transplantation Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

BACKGROUND With the increasing use of extended-criteria donor organs,the interest around Ttubes in liver transplantation(LT)was restored whilst concerns regarding T-tuberelated complications *** To describe insertion and removal protocols implemented at our institution to safely use pediatric rubber 5-French T-tubes and subsequent outcomes in a consecutive series of adult *** Data of consecutive adult LT patients from brain-dead donors,treated from March 2017 to December 2019,were collected(i.e.,biliary complications,adverse events,treatment after T-Tube removal).Patients with upfront hepaticojejunostomy,endoscopically removed T-tubes,those who died or received retransplantation before T-tube removal were *** Seventy-two patients were included in this study;T-tubes were removed 158 d(median;IQR 128-206 d)after *** four(5.6%)patients accidental T-tube removal occurred requiring monitoring only;in 68(94.4%)patients Nelaton drain insertion was performed according to our protocol,resulting in 18(25%)patients with a biliary output,subsequently removed after 2 d(median;IQR 1-4 d).Three(4%)patients required endoscopic retrograde cholangiopancreatography(ERCP)due to persistent Nelaton drain ***(4%)patients developed suspected biliary peritonitis,requiring ERCP with sphincterotomy and nasobiliary drain insertion(only one revealing contrast extravasation);no patient required percutaneous drainage or emergency *** The use of pediatric rubber 5-French T-tubes in LT proved safe in our series after insertion and removal procedure refinements.

关键词： Liver transplantation T-tube Kehr Biliary fistula Endoscopic retrograde cholangio-pancreatography Biliary drainage

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Molecular bases of Sorcin-dependent resistance to chemotherapeutic agents

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Cancer Drug Resistance 2018年第3期1卷 164-180页

作者： Ilaria Genovese andrea Ilari Theo Battista Valerio Chiarini francesco Fazi Annarita Fiorillo Gianni Colotti Department of Radiology Oncology and PathologySapienza University of RomeRome 00161Italy. IBPM-CNR Institute of Molecular Biology and PathologyItalian National Research CouncilRome 00185Italy. Department of Biochemical Sciences Sapienza University of RomeRome 00185Italy. Institute of Biotechnology University of HelsinkiHelsinki 00014Finland. Department of Anatomical HistologicalForensic Medicine&Orthopedic SciencesSapienza University of Romelaboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci BolognettiRome 00161Italy

Soluble resistance-related calcium binding protein(Sorcin)is a protein initially labelled“resistance-related”,since it is co-amplified with ABCB1 in multidrug(MD)-resistant *** for years Sorcin overproduction was believed to be a by-product of the co-amplification of its gene with the P-glycoprotein gene,many recent studies view Sorcin as an oncoprotein,playing an important role in MD resistance(MDR).Sorcin is one of the most highly expressed calciumbinding proteins,which is overexpressed in many human tumors and MD resistant cancers,and represents a novel MDR *** expression in tumors inversely correlates with patients’response to chemotherapies and overall *** is highly expressed in MDR cell lines over their parent *** overexpression by gene transfection increases drug resistance to a variety of chemotherapeutic drugs in many cancer *** the other hand,Sorcin silencing leads to reversal of drug resistance in many cell *** review describes:(1)the roles of Sorcin in the cell;(2)the studies showing Sorcin overexpression in tumors and cancer cells;(3)the studies showing the effects of Sorcin overexpression and silencing;(4)the molecular effects of Sorcin overexpression;and(5)the structural and genetic bases of Sorcin-dependent MDR.

关键词： Sorcin calcium cancer multidrug resistance in cancer doxorubicin endoplasmic reticulum heart brain ryanodine receptors ER stress

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***-term recovery of normal sexual function in lesticular cancer survivors

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Asian Journal of Andrology 2016年第1期18卷 85-89页

作者： Paolo Capogrosso Luca Boeri Matteo Ferrari Eugenio Ventimiglia Giovanni La Croce Umberto Capitanio Alberto Briganti Rocco Damiano francesco Montorsi andrea Salonia Universita Vita-Salute San Raffaele Milan Italy Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele Milan Italy Research Doctorate Program in Urology Magna Graecia University Catanzaro Italy

Testicular cancer （TC） is the most common solid cancer in men between the third and fourth decade of life. Due to successful treatment approaches, TC survivors （TCSs） have long life expectancy, but with numerous potential long-term sequelae, including sexual dysfunction. We investigated predictors of long-term normal sexual function （SF） recovery in TCSs. Sociodemographic, medical, and psychometric data were analyzed in 143 Caucasian-European TCSs, who underwent orchiectomy at a single institution. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI）. Patients completed the International Index of Erectile Function （IIEF）. Statistical models tested the association between predictors （including age at surgery, body mass index, CCI, and adjuvant therapy： radiotherapy [RT], chemotherapy [CT], CT followed by retroperitoneal lymph node dissection [RPLND] and RPLND alone） and the long-term recovery of normal SF （defined as IIEF-erectile function [EF] ≥26, and sexual desire [SD], intercourse satisfaction [IS] orgasmic function [OF], and overall satisfaction [OS] domain scores in the upper tertiles）. At a mean follow-up of 86 months, 35 （25.5%） TCSs had erectile dysfunction （ED）, with 16 （11.2%） experiencing severe ED. Median time of EF recovery was 60, 60, and 70 months after CT, RT, and RPLND, respectively. Only adjuvant RT emerged as an independent predictor of nonrecovery of normal EF （HR： 0.55, P = 0.01）. Neither adjuvant CT nor CT plus RPLND or RPLND alone significantly impaired the recovery of normal erections. Adjuvant therapy was not associated with impaired recovery of normal sexuality as a whole, considering the IIEF-SD, -OF, -IS, and OS domains.

关键词： chemotherapy erectile dysfunction radiotherapy retroperitoneal lymph node dissection survivors testicular cancer

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Impaired coagulation,liver dysfunction and COVID-19:Discovering an intriguing relationship

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World Journal of Gastroenterology 2022年第11期28卷 1102-1112页

作者： Damiano D'Ardes andrea Boccatonda Giulio Cocco Stefano Fabiani Ilaria Rossi Marco Bucci Maria Teresa Guagnano Cosima Schiavone francesco Cipollone “Clinica Medica”Institute Department of Medicine and Aging Sciences“G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy Unit of Ultrasound “G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy

Coronavirus disease 2019(COVID-19)is,at present,one of the most relevant global health *** the literature hepatic alterations have been described in COVID-19 patients,and they are mainly represented by worsening of underlying chronic liver disease leading to hepatic decompensation and liver failure with higher *** potential mechanisms used by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)to cause liver damage have been ***-19 primary liver injury is less common than secondary liver *** of the available data demonstrate how liver damage in SARSCo V-2 infection is likely due to systemic inflammation,and it is less likely mediated by a cytopathic effect directed on liver ***,liver alterations could be caused by hypoxic injury and drugs(antibiotics and non-steroidal antiinflammatory drugs,remdesivir,tocilizumab,tofacitinib and dexamethasone).SARS-Co V-2 infection can induce multiple vascular district atherothrombosis by affecting simultaneously cerebral,coronary and peripheral vascular *** in the literature highlight how the virus triggers an exaggerated immune response,which added to the cytopathic effect of the virus can induce endothelial damage and a prothrombotic dysregulation of *** leads to a higher incidence of symptomatic and confirmed venous thrombosis and of pulmonary embolisms,especially in central,lobar or segmental pulmonary arteries,in *** are currently fewer data for arterial thrombosis,while myocardial injury was identified in 7%-17%of patients hospitalized with SARS-Co V-2 infection and 22%-31%in the intensive care unit *** data also revealed a higher occurrence of stroke and more serious forms of peripheral arterial disease in COVID-19 *** dysregulation is observed during the COVID-19 *** platelet count,mildly increased prothrombin time and increased Ddimer are typical laboratory features of patients with severe SAR

关键词： COVID-19 SARS-CoV-2 Liver Coagulation

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Is there a relationship between length of resection and lymph-node ratio in colorectal cancer?

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Gastroenterology Report 2021年第3期9卷 234-240,I0002页

作者： Antonio Zanghi andrea Cavallaro Emanuele Lo Menzo Serena Curella Botta Salvatore Lo Bianco Maria Di Vita francesco Cardi Alessandro Cappellani General and Breast Surgery Unit Department of SurgeryUniversity of CataniaCataniaItaly Department of General Surgery Digestive Disease InstituteCleveland Clinic FloridaWestonFLUSA

Background:The prognosis of colorectal cancer depends on the number of positive lymph nodes(LNþ)and the total number of lymph nodes resected(rLN).This represents the lymph-node ratio(LNR).The aim of our study is to assess how the length of the resected specimen(RL)influences the prognostic values of the ***:We conducted a retrospective study of all the patients operated on for colorectal cancer from 2000 to 2015 at our *** details were *** total number of rLN,the number of LNþ,and the LNR were calculated and measured against the *** receiver-operating characteristic(ROC)curve of patients with LNþwas ***:Of the 670 patients included in our study,337 were men(50.3%)and the mean age was 69.2 *** correlation with prognosis of the LNR is greater than that of the LNR adjusted to RL(LNR/RL),both in subjects with positive nodes(n=312)and in all cases(n=670).The LNR presents a higher prognostic value than LNR/RL and RL in patients with LNþexcept for metastatic recurrence,for which the predictive value appears slightly higher for LNR/*** statistical significance of the maximal divergence in Kaplan–Meier survival plots was demonstrated for the LNR(P=0.043),not for LNR/RL(P=0.373)and RL alone(P=0.314).Conclusion:An increase in RL causes an increase in the number of harvested lymph nodes without affecting the number of LNþ,thus representing a confounding factor that could alter the prognostic value of the *** larger-scale studies are needed to confirm these findings.

关键词： colorectal cancer lymph-node ratio resection length prognostic value

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Local ablation of pancreatic tumors: State of the art and future perspectives

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World Journal of Gastroenterology 2021年第23期27卷 3413-3428页

作者： Vincenza Granata Roberta Grassi Roberta Fusco andrea Belli Raffaele Palaia Gianpaolo Carrafiello Vittorio Miele Roberto Grassi Antonella Petrillo francesco Izzo Department of Radiology Istituto Nazionale Tumori–IRCCS-Fondazione G.PascaleNaples 80131Italy Department of Radiology Universitàdegli Studi della Campania Luigi VanvitelliNaples 80127Italy Department of Surgery Istituto Nazionale Tumori–IRCCS-Fondazione G.PascaleNaples 80131Italy Department of Surgery Universitàdegli Studi di MilanoMilano 20122Italy Italian Society of Medical and Interventional Radiology SIRM SIRM Foundation Milan 20122Italy Department of Emergency Radiology San Camillo HospitalFirenze 50139Italy

BACKGROUND Currently,the technologies most commonly used to treat locally advanced pancreatic cancer are radiofrequency ablation(RFA),microwave ablation,and irreversible(IRE)or reversible electroporation combined with low doses of chemotherapeutic *** To report an overview and updates on ablative techniques in pancreatic *** Several electronic databases were *** search covered the years from January 2000 to January ***,the reference lists of the found papers were analysed for papers not indexed in the electronic *** titles and abstracts were *** We found 30 studies(14 studies for RFA,3 for microwave therapy,10 for IRE,and 3 for electrochemotherapy),comprising 1047 patients,which were analysed *** randomized trials were found for *** and laparotomy approaches were *** the assessed patients,the median maximal diameter of the lesions was in the range of 2.8 to 4.5 *** series included patients unfit for surgical treatment,but Martin et al assessed a subgroup of patients with borderline resectable tumours who underwent resection with margin attenuation with *** studies administered chemotherapy prior to ablative ***,several studies suggest that the key determinant of improved survival is attributable to ablative treatment ***,the authors suggested chemotherapy before local therapies for several *** strategy may not only downstage a subgroup of patients to curative-intent surgery but also support to recognize patients with biologically unfavourable tumours who would likely not benefit from ablation *** therapies seem safe based on the 1047 patients assessed in this *** mortality rate ranged from 1.8%to 2%.However,despite the low mortality,the reported rates of severe post procedural complications ranged from 0%-42%.Most reported complications have been self-limiting and *** overall survival varied betwe

关键词： Pancreatic cancer Ablation treatment Radiofrequency ablation Microwave ablation Irreversible Electrochemotherapy

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Ultrasound imaging of abdominal sarcoidosis: State of the art

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World Journal of Clinical Cases 2019年第7期7卷 809-818页

作者： Claudio Tana Cosima Schiavone andrea Ticinesi Fabrizio Ricci Maria Adele Giamberardino francesco Cipollone Mauro Silingardi Tiziana Meschi Christoph F Dietrich Internal Medicine and Critical Subacute Care Unit Medicine Geriatric-Rehabilitation Department and Department of Medicine and Surgery University-Hospital of Parma Department of Internistic Ultrasound "G. D’Annunzio" University of Chieti Department of Imaging and Clinical Sciences Institute for Advanced Biomedical Technologies "G. D’Annunzio" University of Chieti Geriatrics Clinic Department of Medicine and Science of Aging"G. D’Annunzio" University of Chieti Medical Clinic Department of Medicine and Science of Aging "G.D’Annunzio" University of Chieti Internal Medicine Unit Maggiore Hospital of Bologna Caritas-Krankenhaus Bad Mergentheim Academic Teaching Hospital of the University of Würzburg

Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.

关键词： Sarcoidosis Sarcoid lesions Granulomatous disorders Liver Spleen Rare diseases Ultrasound Contrast-enhanced ultrasound

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Metabolic syndrome in White-European men presenting for secondary couple＇s infertility： an investigation of the clinical and reproductive burden

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Asian Journal of Andrology 2017年第3期19卷 368-373页

作者： Eugenio Ventimiglia Paolo Capogrosso Alessandro Serino Luca Boeri Michele Colicchia Giovanni La Croce Roberta Scano Enrico Papaleo Rocco Damiano francesco Montorsi andrea Salonia Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele 20132 Milan Italy University Vita-Salute San Raffaele 20132 Milan Italy Infertility Unit Unit of Obstetrics/Gynecology IRCCS Ospedale San Raffaele 20132 Milan Italy Research Doctorate Program in Urology Magna Graecia University 88020 Catanzaro Italy.

We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI; categorised 0 vs I vs 2 or higher）. NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization （WHO） reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 （12%） of 167 men. Patients with MetS were older （P 〈 0.001） and had a greater BMI （P 〈 0.001） compared with those without MetS. MetS patients had lower levels of total testosterone （P = 0.001）, sex hormone-binding globulin, inhibin B, and anti-MOIlerian hormone （all P 〈 0.03）, and they were hypogonadal at a higher prevalence （P = 0.01） than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology （all P≤0.03）. At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple＇s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.

关键词： infertility metabolic syndrome sperm count

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Severe male factor in in vitro fertilization:definition,prevalence,and *** update

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Asian Journal of Andrology 2022年第2期24卷 125-134页

作者： Rossella Mazzilli Alberto Vaiarelli Lisa Dovere Danilo Cimadomo NicolòUbaldi Susanna Ferrero Laura Rienzi francesco Lombardo andrea Lenzi Herman Tournaye Filippo Maria Ubaldi Clinica Valle Giulia GeneraLife IVF CentersVia G.De NotarisRome 2B 00197Italy Department of Clinical and Molecular Medicine University of Rome“Sapienza”Via di Grottarossa 1035Rome 00189Italy Catholic University of the Sacred Heart Via della Pineta Sacchetti 217Rome 00168Italy Department of Experimental Medicine “Sapienza”University of RomeViale del Policlinico 155Rome 00161Italy Centre for Reproductive Medicine Free University Brussels(UZ Brussel)Brussels 1090Belgium

Infertility affects 10%–15%of couples *** all infertility cases,20%–70%are due to male *** the past,men with severe male factor(SMF)were considered ***,the development of intracytoplasmic sperm injection(ICSI)drastically modified this *** advances in assisted reproductive technology(ART),specifically regarding surgical sperm retrieval procedures,allowed the efficacious treatment of these ***,before undergoing ICSI,male factor infertility requires careful evaluation of clinical and lifestyle behavior together with medical *** speaking,women whose male partner is azoospermic tend to be younger and with a better ovarian *** couples,in fact,are proposed ART earlier in their life,and for this reason,their ovarian response after stimulation is generally ***,in younger couples,azoospermia can be partially compensated by the efficient ovarian response,resulting in an acceptable fertility rate following in vitro fertilization(IVF)***,when azoospermia is associated with a reduced ovarian reserve and/or advanced maternal age,the treatment becomes more challenging,with a consequent reduction in IVF ***,azoospermia seems to impair neither the euploidy rate at the blastocyst stage nor the implantation of euploid *** on the current knowledge,the assessment of male infertility factors should involve:(1)evaluation–to diagnose and quantify seminologic alterations;(2)potentiality–to determine the real possibilities to improve sperm parameters and/or retrieve spermatozoa;(3)time–to consider the available“treatment window”,based on maternal age and ovarian *** review represents an update of the definition,prevalence,causes,and treatment of SMF in a modern ART clinic.

关键词： azoospermia in vitro fertilization infertility intracytoplasmic sperm injection severe male factor sperm

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Boswellia resin extract and propolis derived polyphenols in patients with type III chronic prostatitis/chronic pelvic pain syndrome:An Italian prospective multicenter study

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Asian Journal of Urology 2022年第2期9卷 139-145页

作者： Fabrizio Presicce francesco Barrese andrea Cantiani Alessio Filianoti Domenico Tuzzolo Paolo Di Palma Stefano Lauretti Stefano Brunori Marco Martini San Filippo Neri Hospital Department of UrologyRomeItaly Sant’Eugenio Hospital Department of UrologyRomeItaly Casa del Sole Clinic Department of UrologyFormiaItaly Fabrizio Spaziani Hospital Department of UrologyFrosinoneItaly Santa Caterina della Rosa Clinic Department of UrologyRomeItaly Villa Stuart Clinic Department of UrologyRomeItaly

Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive *** were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week *** endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total *** outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI ***:A total of 61 males were *** adverse events were *** improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were *** final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were ***:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.

关键词： Boswellia serrata Chronic prostatitis Chronic pelvic pain syndrome Propolis Treatment

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