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Giant cavernous liver hemangiomas： is it the time to change the size categories？

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 21-29页

作者： isidoro di carlo renol koshy saif al mudares annalisa ardiri gaetano bertino adriana toro departments of general surgery hamad general hospitalDohaQatar department of surgical sciences and advanced technologies"g.f.ingrassia" university of cataniaCataniaItaly hepatology unit department of medical and pediatric scienceuniversity of cataniaCataniaItaly department of surgery patti hospitalMessinaItaly

BACKGROUND： Four different sizes （4, 5, 8 and 10 cm in diameter） can be found in the literature to categorize a liver hemangioma as giant. The present review aims to clarify the appropriateness of the size category ＂giant＂ for liver heman- gioma. DATA SOURCES： We reviewed the reports on the categoriza- tion of hemangioma published between 1970 and 2014. The number of hemangiomas, size criteria, mean and range of hemangioma sizes, and number of asymptomatic and symp- tomatic patients were investigated in patients aged over 18 years. Liver hemangiomas were divided into four groups：〈5.0 cm, 5.0-9.9 cm, 10.0-14.9 cm and 〉15.0 cm in diameter. Inclu- sion criteria were noted in 34 articles involving 1972 （43.0%） hemangiomas （〉4.0 cm）. RESULTS： The patients were divided into the following groups： 154 patients （30.0%） with hemangiomas less than 5.0 cm in diameter （small）, 182 （35.5%） between 5.0 cm and 9.9 cm （large）, 75 （14.6%） between 10.0 and 14.9 cm （giant）, and 102 （19.9%） more than 15.0 cm （enormous）. There were 786 （39.9%） asymptomatic patients and 791 （40.1%） symptomatic patients. Indications for surgery related to symptoms were reported in only 75 （3.8%） patients. Operations including 137 non-anatomical resection （12.9%） and 469 enudeation （44.1%） were undearly related to size and ***： The term ＂giant＂ seems to be justified for liver hemangiomas with a diameter of 10 cm. Hemangiomas categorized as ＂giant＂ are not indicated for surgery. Surgery should be performed only when other symptoms are apparent.

关键词： giant hemangioma cavernous hemangioma liver hemangioma

Chronic hepatitis C:This and the new era of treatment

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World Journal of Hepatology 2016年第2期8卷 92-106页

作者： gaetano bertino Annalisa Ardiri Maria Proiti Giuseppe Rigano Evelise Frazzetto Shirin Demma MariaIrene Ruggeri Laura Scuderi Giulia Malaguarnera Nicoletta bertino Venerando Rapisarda Isidoro Di Carlo Adriana Toro Federico Salomone Mariano Malaguarnera Emanuele bertino Michele Malaguarnera Hepatology Unit-Department of Clinical and Experimental Medicine University of Catania95123 CataniaItaly Internal Medicine Unit ARNAS Civic Hospital90142 PalermoItaly Research Centre“La Grande Senesce” University of Catania95100 CataniaItaly Department of Biomedical Sciences University of Catania95100 CataniaItaly Faculty of Pharmacy University of Catania95123 CataniaItaly Occupational Medicine Unit Department of Clinical and Experimental MedicineUniversity of Catania95100 CataniaItaly Department of Surgical Sciences Organ Transplantation and Advanced TechnologiesUniversity of Catania95100 CataniaItaly Gastroenterology Unit Acireale Hospital95024 AcirealeCataniaItaly

Over the last years it has started a real revolution in the treatment of chronic hepatitis C. This occurred for the availability of direct-acting antiviral agents that allow to reach sustained virologic response in approximately 90% of cases. In the near future further progress will be achieved with the use of pan-genotypic drugs with high efficacy but without side effects.

关键词： Direct-acting antiviral agents Nucleosideinhibitors Boceprevir Sofosbuvir Telaprevir HepatitisC Simeprevir Daclatasvir Ledipasvir Faldaprevir Ritonavir Ombitasvir Dasabuvir

Hepatocellular carcinoma and the risk of occupational exposure

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World Journal of Hepatology 2016年第13期8卷 573-590页

作者： Venerando Rapisarda Carla Loreto Michele Malaguarnera Annalisa Ardiri Maria Proiti Giuseppe Rigano Evelise Frazzetto Maria Irene Ruggeri Giulia Malaguarnera Nicoletta bertino Mariano Malaguarnera Vito Emanuele Catania Isidoro Di Carlo Adriana Toro Emanuele bertino Dario Mangano gaetano bertino Occupational Medi-cine Unit Department of Clinical and Experimental MedicineUniversity of Catania Department of Biomedical Sciences Human Anatomy and Histology Section University of Catania Department of Biomedical Sciences University of Catania Hepatology Unit Department of Clinical and Experimental Medicine University of Catania Internal Medicine Unit ARNAS Civic Hospital Research Centre "La Grande Senescenza" University of Catania Faculty of Pharmacy University of Catania Department of Surgical Sciences Organ Transplantation and Advanced TechnologiesUniversity of Catania

Hepatocellular carcinoma(HCC)is the most common type of liver *** main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and *** exposure to chemicals is another risk factor for *** the relationship between occupational risk and HCC is unclear and the reports are fragmented and *** review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.

关键词： Hepatocellular carcinoma Autophagy Epigenetic events Hepatitis B virus Hepatitis C virus Occupational exposure Chemical agents Mitophagy Arsenic Cadmium

Circulating adhesion molecules in patients with virus-related chronic diseases of the liver

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World Journal of Gastroenterology 2005年第29期11卷 4566-4569页

作者： Cosimo Marcello Bruno Claudio Sciacca Danila Cilio gaetano bertino Anna Elisa Marchese Gaetana Politi Lucia Chinnici Department of Internal Medicine and Systemic Diseases University of Catania Italy Lucia Chinnici Clinical Laboratory Analysis S. Bambino Hospital Catania Italy

AIM: In the inflammatory state, intercellular adhesion molecule-1 (ICAM-1) and vascular cellular adhesion molecule-1 (VCAM-1) play a key role in promoting migration of immunological cells from the circulation to target *** of our study was to investigate soluble forms of these molecules in patients with virus-related chronic liver diseases, to assess their behavior in different pathologies and correlation with severity of liver ***: Circulating ICAM-1 and VCAM-1 were assayed by EIA commercial kits (R&D System Co.,Abington, UK) in 23 patients with chronic active hepatitis (CH), 50 subjects affected by liver cirrhosis (LC) and 15 healthy controls comparable for sex and age. In patients, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected by ***: LC patients had significantly higher ICAM-1 values than CH patients (38.56±7.4 ng/mL vs 20.89±6.42 ng/mL; P＜0.001) and these ones had significantly higher values than controls (12.92±1.08 ng/mL; P＜0.001). In CH group, ICAM-1 levels were significantly related to inflammatory activity (P= 0.041) and ALT values (r= 0.77;P＜0.05). VCAM-1 values were significantly increased only in LC patients (P＜0.001) and related to severity of liver ***: These findings suggest that the determination of serum ICAM-1 can be considered as an additional useful marker of hepatocellular necrosis and inflammatory activity in chronic hepatitis, while serum VCAM-1 is an indicator of liver fibrogenesis and severity of disease in cirrhosis.

关键词： ICAM-1 VCAM-1 Chronic liver diseases Hepatocellular necrosis Liver fibrosis

Responsibility of hepatitis C virus in the development of hepatocellular carcinoma:From molecular alterations to possible solutions

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World Journal of Hepatology 2018年第6期10卷 448-451页

作者： gaetano bertino Giulia Malaguarnera Evelise Frazzetto Alice Sciuto gaetano Inserra Guido Nicola Zanghì Michele Malaguarnera Hepatology Unit Department of Clinical and Experimental MedicineUniversity of CataniaPoliclinico“G.Rodolico”Catania 95123Italy Research Center“the Great Senescence” University of CataniaCatania 95100Italy Department of Biomedical and Biotechnological Science University of CataniaCatania 95100Italy Department of Clinical and Experimental Medicine University of CataniaCatania 95123Italy Department of Surgery Policlinico Vittorio Emanuele University HospitalUniversity of CataniaCatania 95100Italy

There are several causes of hepatocellular carcinoma(HCC), but certainly the hepatitis C virus(HCV) is one of the most common. The HCV is able to contribute, both directly and indirectly, to the development of HCC. Determining early HCV clearance before an advanced liver disease develops, is absolutely necessary as this prevents the initiation of the cascade of events induced by HCV that may result in the development of HCC. The early treatment of the infection and the clearance of HCV represents today, in the age of the direct antiviral agents(DAAs), an extraordinary opportunity for true prevention of the development of HCV-related HCC.

关键词： Hepatitis C virus Hepatocellular carcinoma Inflammation Fibrosis Insulin-resistance Oxidative stress Direct acting antivirals

Erythropoietin in liver cirrhosis: Two questions without answers

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World Journal of Gastroenterology 2005年第23期11卷 3649-3649页

作者： Cosimo Marcello Bruno Claudio Sciacca Danila Cilio gaetano bertino Rinaldo Pellicano Department of Internal Medicine and Systemic Diseases Department of Gastro-Hepatology

TO THE EDITORIn a recent paper[1], and in a subsequent letter[2], Tacke et al. reported the investigation of plasma erythropoietin (Epo) levels in patients affected by chronic liver disease of various aetiologies. The authors also compared[2] their data to our previous work[3]. The results show a substantial agreement but also some important differences between the two works. We would like to highlight, from our point of view, this issue. Both the papers demonstrated increased Epo values in anaemic cirrhotic subjects when compared to healthy controls and non-anemic patients with liver disease.

关键词： Erythropoietin Liver cirrhosis

Plasma erythropoietin levels in anaemic and non-anaemic patients with chronic liver diseases

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World Journal of Gastroenterology 2004年第9期10卷 1353-1356页

作者： Cosimo MarcelloBruno Sergio Neri ClaudioSciacca gaetano bertino Pietro DiPrima Danila Cilio Luciano Caruso Raffaello Cristaldi Rinaldo Pellicano Department of Internal Medicine and Sistemic Diseases University of CataniaItaly Department of Gastro-Hepatology Molinette HospitalTorinoItaly

AIM: To investigate the serum erythropoietin (Epo) levels in patients with chronic liver diseases and to compare to subjects with iron-deficiency anaemia and healthy ***: We examined 31 anaemic (ALC) and 22 non-anaemic (NALC) cirrhotic patients, 21 non-anaemic subjects with chronic active hepatitis (CAH), 24 patients with iron-deficiency anaemia (ID) and 15 healthy controls. Circulating Epo levels (ELISA; R&D Systems, Europe Ltd, Abingdon,UK) and haemoglobin (Hb) concentration were determined in all ***: Mean±SD of Epo values was 26.9±10.8 mU/mL in ALC patients, 12.5±8.0 mU/mL in NALC subjects,11.6±6.3 mU/mL in CAH patients, 56.4±12.7 mU/mL in the cases of ID and 9.3±2.6 mU/mL in controls. No significant difference (P>0.05) was found in Epo levels between controls, CAH and NALC patients. ALC individuals had higher Epo levels (P<0.01) than these groups whereas ID subjects had even higher levels (P<0.001) than patients suffering from ***: Increased Epo values in cirrhotics, are only detectable when haemoglobin was lesser than 12 g/***, this rise in value is lower than that observed in anaemic patients with iron-deficiency and appears blunted and inadequate in comparison to the degree of anaemia.

关键词： Aged Anemia, Iron-Deficiency Erythropoietin Female Hemoglobins Hepatitis, Chronic Humans Liver Cirrhosis Male Middle Aged Regression Analysis

Endozepine-4 levels are increased in hepatic coma

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World Journal of Gastroenterology 2015年第30期21卷 9103-9110页

作者： Giulia Malaguarnera Marco Vacante Filippo Drago gaetano bertino Massimo Motta Maria Giordano Michele Malaguarnera Research Center "The Great Senescence" Hospital of Cannizzaro University of Catania Department of Clinical and Experimental Medicine University of Catania Department of Biomedical and Biotechnological Sciences Section of PharmacologySchool of MedicineUniversity of Catania Gerontology and Bone Metabolic Disease Section Department of Medical SciencesUniversity of Torino

AIM:To evaluate the serum levels of endozepine-4,their relation with ammonia serum levels,the grading of coma and the severity of cirrhosis,in patients with hepatic coma. METHODS:In this study we included 20 subjects with Hepatic coma,20 subjects with minimal hepatic encephalopathy(MHE) and 20 subjects control. All subjects underwent blood analysis,Child Pugh and Model for End- stage liver disease(MELD) assessment,endozepine-4 analysis. RESULTS:Subjects with hepatic coma showed significant difference in endozepine-4(P < 0.001) and NH3 levels(P < 0.001) compared both to MHE and controls patients. Between NH3 and endozepine-4 we observed a significant correlation(P = 0.009; Pearson correlation 0.570). There was a significant correlation between endozepine-4 and MELD(P = 0.017; Pearsoncorrelation = 0.529). In our study blood ammonia concentration was noted to be raised in patients with hepatic coma,with the highest ammonia levels being found in those who were comatose. We also found a high correlation between endozepine-4 and ammonia(P < 0.001). In patients with grade Ⅳ hepatic coma,endozepine levels were significantly higher compared to other groups. CONCLUSION:This study suggests that an increased level of endozepine in subjects with higher levels of MELD was observed. In conclusion,data concerning involvement of the GABA-ergic system in HE coma could be explained by stage-specific alterations.

关键词： Endozepine-4 Hepatic encephalopathy Hepatic coma Cirrhosis, Benzodiazepine Peripheralbenzodiazepine receptor Model for End - stage liverdisease Glutamate-related neurotoxicity which in turnmay alter the γ-aminobutyric acid

L-carnitine supplementation improves hematological pattern in patients affected by HCV treated with Peg interferon-α 2b plus ribavirin

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World Journal of Gastroenterology 2011年第39期17卷 4414-4420页

作者： Michele Malaguarnera Marco Vacante Maria Giordano Massimo Motta gaetano bertino Manuela Pennisi Sergio Neri Mariano Malaguarnera Giovanni Li Volti Fabio Galvano Department of Biological Chemistry Medical Chemistry and Molecular BiologyUniversity of Catania Department of Internal Medicine and Systemic Disease University of Catania Research Center"The Great Senescence" University of Catania

AIM：To evaluate the efficacy of L-carnitine on alleviating anemia,thrombocytopenia and leukopenia,and minimizing dose reductions in patients with chronic hepatitis C virus（HCV）in treatment with Interferonα（IFN-α）plus ***：Sixty-nine patients with chronic hepatitis C were enrolled in the study and divided into two *** A（n=35）received Peg-IFN-α2b plus ribavirin plus L-carnitine,and group B（n=34）received Peg-IFN-αand ribavirin for 12 *** patients underwent laboratory investigations including：red cell count,he-moglobin,white cell count,platelets,bilirubin,alanineaminotransferase（ALT）,aspartate aminotransferase（AST）,and ***：After 12 mo in group A compared to group B we observed significant differences in AST 108.8 vs 76.8（IU/L;P0.001）,ALT *** 112.3（IU/L;P 0.001）,viremia 4.04 vs 2.36（106 copies/mL;P 0.001）,Hb 1 vs 3.5（g/dL;P0.05）,red blood cells 0.3 vs 1.1（1012/L;P0.001）,white blood cells 1.5 vs 3（10/L;P0.001）and platelets 86 vs 85（×10/L;P0.001）.The end treatment responders were 18 vs 12（60%vs 44%）and the non responders were 12 vs 15（40%vs 50%）[odds ratio（OR）1.65,5%CI =0.65-5.37,*** group A compared to group B there was a significant improvement of sustained vi-rological response in 15 vs 7 patients（50%vs25%）,while the relapsers were 3 vs 5（10%vs 18%）（OR 3.57,5%CI=0.65-1.3,P0.001）.CONCLUSION：L-carnitine supplementations modulate erythropoiesis,leucopoiesis and thrombocytopoiesis,and may be useful in patients treated for HCV.L-carni-tine treatment offers the possibility of achieving a sus-tained virological response while preventing overtreat-ment.

关键词： L-carnitine Chronic hepatitis C Anemia In-terferon