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Surgical treatment of ulcerative colitis in the biologic therapy era

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World Journal of Gastroenterology 2012年第16期18卷 1861-1870页

作者： Alberto Biondi Marco Zoccali Stefano Costa Albert Troci ettore Contessini-Avesani Alessandro Fichera Emergency and General Surgery Unit Fondazione IRCCS "Ca' Granda" Policlinico Maggiore20122 MilanItaly Department of Surgery University of Chicago Medical CenterChicagoIL 60637United States First General Surgery Unit Department of SurgeryCatholic University00168 RomeItaly

Recently introduced in the treatment algorithms and guidelines for the treatment of ulcerative colitis,biological therapy is an effective treatment option for patients with an acute severe flare not responsive to conventional treatments and for patients with steroid dependent *** reduction in hospitalization and surgical intervention for patients affected by ulcerative colitis after the introduction of biologic treatment remains to be ***,these agents seem to be associated with increase in cost of treatment and risk for serious postoperative *** proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in ulcerative colitis *** is traditionally recommended as salvage therapy when medical management fails,and,despite advances in medical therapy,colectomy rates remain unchanged between 20% and 30%.To overcome the reported increase in postoperative complications in patients on biologic therapies,several surgical strategies have been developed to maintain long-term pouch failure rate around 10%,as previously *** staging along with the development of minimally invasive surgery are among the most promising advances in this field.

关键词： Ulcerative colitis Inflammatory bowel disease Infliximab Surgery Laparoscopy Single incision laparoscopy Total abdominal colectomy Ileal pouch anal anastomosis Restorative proctocolectomy

A novel expressed prostatic secretion(EPS)-urine metabolomic signature for the diagnosis of clinically significant prostate cancer

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Cancer Biology & Medicine 2021年第2期18卷 604-615页

作者： Denise Drago Annapaola Andolfo ettore Mosca Alessandro Orro Luigi Nocera Vito Cucchiara MatteoBellone Francesco Montorsi Alberto Briganti ProMeFa Proteomics and Metabolomics FacilityCenter for Omics Sciences(COSR)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Institute of Biomedical Technologies National Research Council(CNR)Milan 20090Italy Department of Urology and Division of Experimental Oncology Urological Research Institute(URI)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Division of Immunology Transplantation and Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilan 20132Italy

Objective:Significant efforts are currently being made to identify novel biomarkers for the diagnosis and risk stratification of prostate cancer(PCa).Metabolomics can be a very useful approach in biomarker discovery because metabolites are an important read-out of the disease when characterized in biological *** aimed to determine a metabolomic signature which can accurately distinguish men with clinically significant PCa from those affected by benign prostatic hyperplasia(BPH).Methods:We first performed untargeted metabolomics using ultrahigh-performance liquid chromatography tandem mass spectrometry on expressed prostatic secretion urine(EPS-urine)from 25 patients affected by BPH and 25 men with clinically significant PCa(defined as Gleason score≥3+4).Diagnosis was histologically confirmed after surgical *** EPS-urine metabolomic approach was then applied to a larger,prospective cohort of 92 consecutive patients undergoing multiparametric magnetic resonance imaging for clinical suspicion of PCa prior to ***:We established a novel metabolomic signature capable of accurately distinguishing PCa from benign tissue.A metabolomic signature was associated with clinically significant PCa in all subgroups of the Prostate Imaging Reporting and Data System(PI-RADS)classification(100%and 89.13%of accuracy when the PI-RADS was in range of 1–2 and 4–5,respectively,and 87.50%in the more critical cases when the PI-RADS was 3).Conclusions:A combination of metabolites and clinical variables can effectively help in identifying PCa patients that might be overlooked by current imaging *** from EPS-urine should help in defining the diagnostic pathway of PCa,thus improving PCa detection and decreasing the number of unnecessary prostate biopsies.

关键词： Prostate cancer EPS-urine metabolomics prediction diagnosis

Radiological imaging and non-surgical local treatments for cholangiocarcinoma

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Hepatoma Research 2022年第1期8卷 50-64页

作者： Angelo Della Corte ettore Di Gaeta Stephanie Steidler Francesco De Cobelli Department of Radiology IRCCS San Raffaele Scientific Institute20132 MilanItaly Vita-Salute University 20132 MilanItaly Experimental Imaging Center IRCCS San Raffaele Scientific Institute20132MilanItaly

Cholangiocarcinoma(CC)is a malignancy with a very heterogeneous spectrum of morphopathological and prognostic *** imaging is fundamental for early detection,preoperative staging,and resectability assessment,as well as early recognition of prognostic *** surgical treatment is limited by disease stage and technical *** radiology has acquired a critical function in addressing disease control and survival improvement through loco-regional therapies,specifically in the setting of intrahepatic *** this review,we will describe the current state of art of diagnostic imaging,focusing on intrahepatic CC and proximal extrahepatic CC,and delineate the available loco-regional therapies strategies for unresectable intrahepatic CC.

关键词： Cholangiocarcinoma diagnostic imaging loco-regional therapies ablation embolization

emerging role of the β-catenin-PPARγ axis in the pathogenesis of colorectal cancer

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World Journal of Gastroenterology 2014年第23期20卷 7137-7151页

作者： Lina Sabatino Massimo Pancione Carolina Votino Tommaso Colangelo Angelo Lupo ettore Novellino Antonio Lavecchia Vittorio Colantuoni Department of Sciences and Technologies University of Sannio Department of Pharmacy "Drug Discovery" LaboratoryUniversity of Naples "Federico Ⅱ"80131 NaplesItaly

Multiple lines of evidence indicate that Wnt/β-catenin signaling plays a fundamental role in colorectal cancer (CRC) initiation and progression. Recent genome-wide data have confirmed that in CRC this pathway is one of the most frequently modified by genetic or epigenetic alterations affecting almost 90% of Wnt/β-catenin gene members. A major challenge is thus learning how the corrupted coordination of this pathway is tied to other signalings to enhance cell growth. Peroxisome proliferator activated receptor γ (PPARγ) is emerging as a growth-limiting and differentiation-promoting factor. In tumorigenesis it exerts a tumor suppressor role and is potentially linked with the Wnt/β-catenin pathway. Based on these results, the identification of new selective PPARγ modulators with inhibitory effects on the Wnt/β-catenin pathway is becoming an interesting perspective. Should, in fact, these molecules display such properties, new research avenues would be opened aimed at developing new molecular targeted drugs. Herein, we review the basic principles and present new hypotheses underlying the crosstalk between Wnt/β-catenin and PPARγ signaling. Furthermore, we discuss the advances in our understanding as to how their altered regulation can culminate in colon cancer and the efforts aimed at designing novel PPARγ agonists endowed with Wnt/β-catenin inhibitory effects to be used as therapeutic and/or preventive agents.

关键词： Colorectal cancer Wnt/β -catenin pathway Peroxisome proliferator-activated receptor γ Genomic instability Peroxisome proliferator activated receptor γ ligands

Predicted and measured soil retention curve parameters in Lombardy region north of Italy

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International Soil and Water Conservation Research 2016年第3期4卷 207-214页

作者： Fatma Wassar Claudio Gandolfi Michele Rienzner Enrico Antonio Chiaradia ettore Bernardoni IBIMET-CNR via Madonna del Piano 1050019 Sesto F.noFIItaly Dipartimento di Scienze Agrarie e Ambientali(DISAA) Universitàdegli Studi di Milano(UNIMI)Via Celoria 220133 MilanoItaly ISSTEG Institut Supérieur des Sciences et Techniques des EauxcitéAmal 46072 GabèsTunisia

Water retention characteristics are fundamental input parameters in any modeling study on water flow and solute *** properties are difficult to measure and for that reason,we usually need to use direct and indirect methods to determine *** extensive comparison between measured and estimated results is needed to determine their applicability for a range of different *** this study attempts to make a contribution specifically in this *** properties were determined in two representative sites located in Landriano field,in Lombardy region,northern *** the laboratory we used the pressure plate apparatus and the tensiometric *** soil water retention was determined including measurements of soil water content with SENTEK probes and matric potential with *** soil waer retention curves(SWRC)were also settled on with some recently developed pedo-transfert functions(PTFs).Field retention curves were compared against those obtained from PTFs estimations and laboratory *** comparison showed that laboratory measurements were the most *** had the highest ranking for the validation indices(RMSE ranging between 2.4%and 7.7%and bias between 0.1%and 6.4%).The second best technique was the PTF Rosetta(Schaap et al.2001).They perform only slightly poorer than the laboratory measurements(RMSE ranging between 2.7%and 10%and bias between 0.3%and 7.7%).The lowest prediction accuracy is observed for the Rawls and Brakensiek(1985)PTF(RMSE ranging between 6.3%and 17%and bias between 5%and 10%)which is in contradiction with previous finding(Calzolari et al.,2001),showing that this function is well representing the retention characteristics of the *** to time and cost investments of laboratory and field measurements,we conclude that the Rosetta PTF developed by Schaap et al.(2001)appears to be the best to predict the soil moisture retention curve from easily available soil properties in the Lombardy area a

关键词： Comparison Laboratory water retention Field measurements Curve measurements Pedo-transfert functions

Long-term results of suppressing thyroid-stimulating hormone during radiotherapy to prevent primary hypothyroidism in medulloblastoma/PNET and Hodgkin lymphoma:a prospective cohort study

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Frontiers of Medicine 2021年第1期15卷 101-107页

作者： Maura Massimino Marta Podda Lorenza Gandola Emanuele Pignoli ettore Seregni Carlo Morosi Filippo Spreafico Andrea Ferrari Emilia Pecori Monica Terenziani Pediatric Oncology Unit Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20146Italy Pediatric Radiotherapy Unit Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20146Italy Medical Physics Unit Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20146Italy Department of Nuclear Medicine Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20146Italy Department of Radiology Fondazione IRCCS Istituto Nazionale dei TumoriMilan 20146Italy

Primary hypothyroidism commonly occurs after radiotherapy(RT),and coincides with increased circulating thyroid-stimulating hormone(TSH)*** tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma(HL)in a prospective cohort *** 1998 to 2001,a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL,scheduled for craniospinal irradiation and mediastinum/neck radiotherapy,respectively,underwent thyroid ultrasound and free triiodothyronine(FT3),free thyroxine(FT4),and TSH evaluation at the beginning and end of craniospinal *** 14 days before and up to the end of radiotherapy,patients were administered L-thyroxine checking every 3 days TSH to ensure a value<0.3μIU/*** follow-up,blood tests and ultrasound were repeated;primary hypothyroidism was considered an increased TSH level greater than normal ***-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels˂0.3μIU/mL and well matched for other *** years on,hypothyroidism-free survival rates differed significantly,being 60%±15%and 15.6%±8.2%in TSH-suppressed ***-TSH suppressed patients,respectively(P=0.001).These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae,but it should be confirmed in a larger cohort.

关键词： iatrogenic primary hypothyroidism late effects of radiotherapy long-term follow-up medulloblastoma Hodgkin lymphoma

ADRs and Children： Knowledge and Methodological Standard in PASS （Post Authorization Safety Studies）

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Journal of Pharmacy and Pharmacology 2017年第6期5卷 314-322页

作者： ettore Napoleone Cristiana Scasserra FP-MCRN (Family Pediatricians - Medicines for Children Research Network) 86100 Campobasso Italy

PhV （pharmacovigilance） knowledge has the outcome of being inadequate in particular due to the lack of instruction. Pediatricians have to face the realization that over-the-counter medicines increments the peril of ADRs （adverse drug reactions） has become a public health concern. The purpose of this article is to disseminate knowledge of the PhV and to highlight the cultural and organizational difficulties for its implementation. The objectives of promoting the organization of specific training courses and research projects aimed at：（1） to foster the culture of iatrogenic disease in pediatrics; （2） to improve the appropriateness of prescribing drugs in children; （3） to *** spontaneous reporting of ADRs in children; （4） to involve Pediatricians in PASS （post-authorization safety studies） according to GCP, GVP and ENCEPP Code of Conduct. An up to date proposal of PhV, a procedure of preparation improves the productivity of creating novel informative reports which can be utilized for a benefit/risk scrutiny making strides in medicine prescription. In this context, FP-MCRN （family paediatficians-medicines for children research network） established with the aim of developing competence, infrastructure and education for paediatric clinical trials, plays a crucial role in paediatric PhV, through an improvement of PhV training, a correct research methodology and very strong relationship with the families. The initial necessity is cultural, implementing culture of iatrogenic illnesses and a watchful evaluation of the importance of PASS by FPs （family pediatricians）. Participation in clinical trials that generates a precise database administered by FPs together with follow-up outcomes becomes relevant and vital for a scrupulous and accurate assessment of ADRs. PASS can foresee on one hand training and information regarding the proper use of drugs in children and possible iatrogenic pathologies caused by their improper use, the other to constitute a territorial survey

关键词： Children adverse drug reactions off-label pharmacovigilance post-marketing clinical studies.

Regression of liver metastases of occult carcinoid tumor with slow release Lanreotide therapy

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World Journal of Gastroenterology 2005年第13期11卷 2041-2044页

作者： Marta Bondanelli Maria Rosaria Ambrosio Maria Chiara Zatelli Luigi Cavazzini Laura Al Jandali Rifa'y ettore C.degli Uberti Department of Biomedical Sciences and Advanced Therapies-Section of Endocrinology Department of Experimental and Diagnostic Medicine

Few clinical studies have demonstrated an anti-proliferative activity of somatostatin (SST) analogs in carcinoids. We report the case of a woman with liver metastases of neuroendocrine tumor and no evidence of the primary tumor. The liver metastases were characterized by high proliferation index, immunoreactiviy for somatostatin receptor (SSTR)-l, 2, 3 and 5 and positive octreoscan. Urinary 5-hydroxyindolacetic acid, serum serotonin and chromogranin A were elevated. Slow release lanreotide (SR-LAN) therapy for 3 mo controlled clinical and biochemical signs of carcinoid tumor and caused a clear-cut reduction in the diameter of two liver metastases and disappearance of another lesion, with further reduction after 6 and 18 mo. We demonstrated a clear-cut long-lasting anti-proliferative effect of SR-LAN on liver metastases of occult carcinoid with high proliferation index and immunoreactivity for SSTR-1, 2, 3, and 5. Immunohistochemistry for SSTRs could be a suitable method for the selection of patients with metastatic carcinoid that may benefit from SST analog therapy.

关键词： Carcinoid Somatostatin analogs Somatostatin receptors

Corrective osteotomies of the radius:Grafting or not?

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World Journal of Orthopedics 2016年第2期7卷 128-135页

作者： Raffaele Mugnai Luigi Tarallo Enrico Lancellotti Francesco Zambianchi ettore Di Giovine Fabio Catani Roberto Adani Orthopedics and Traumatology Department Modena PoliclinicUniversity of Modena and Reggio Emilia Department of Hand Surgery and Microsurgery University Hospital Policlinico di Modena

AIM:To review the current literature regarding corrective osteotomies to provide the best evidence of the rule of bone ***:Our MEDLINE literature search included 280 studies using the following key words "Malunited distal radius fracture" and 150 studies using key words "Corrective osteotomy of the distal radius".Inclusion criteria were:Malunited distal radial,extra articular fracture,volar locking plate,use of iliac bone graft(cancellous or corticocancellous),non-use of bone *** studies met the inclusion ***:Seven of the 12 studies considered,described the use of a graft;the remaining five studies didn't use any *** of malunion was dorsal in most of the *** healing time was comparable using the graft or not(mean 12.5 wk),ranging from 7.5 to 16 *** mean disabilities of the arm,shoulder and hand score improvement was 23 points both in the studies that used the graft and in those not using the ***:This review demonstrated that corrective osteotomy of extra-articular malunited fractures of the distal radius treated by volar locking plate does not necessarily require bone graft.

关键词： Radial fracture Osteotomy Graft Volar plate Malunion