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Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini Alessandro Fogliati Mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi antonio Rovere Luca Gianotti Fabrizio Romano Unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-IN”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P<0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound Liver surgery Computed tomography Surgical procedure

Stem cell technology for antitumor drug loading and delivery in oncology

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Oncology Research 2024年第3期32卷 433-437页

作者： FRANCESCO PETRELLA ENRICO MARIO CASSINA LIDIA LIBRETTI EMANUELE PIRONDINI FEDERICO RAVEGLIA antonio TUORO Department of Thoracic Surgery Fondazione IRCCSS an Gerardo dei TintoriMonza20900Italy

The main aim of antineoplastic treatment is to maximize patient benefit by augmenting the drug accumulation within affected organs and tissues,thus incrementing drug effects and,at the same time,reducing the damage of non-involved tissues to cytotoxic *** stromal cells(MSC)represent a group of undifferentiated multipotent cells presenting wide self-renewal features and the capacity to differentiate into an assortment of mesenchymal family *** the last year,they have been proposed as natural carriers for the selective release of antitumor drugs to malignant cll,s thus optimizing cytotoxic action on cancer cll,while significantly reducing adverse side efect on healthy *** chemotherapeutic drug loading and delivery is an encouraging new area of cell therapy for several tumors,especially for those with unsatisfactory prognosis and limited treatment options *** some experim ental models have been sucesfuly developed,phase I dinical studies are needed to confirm this potential application of cell therapy,in particular in the case of primary and secondary lung cancers.

关键词： Mesenchymal stromal cell Drug loading Drug delivery Mesothelioma Melanoma Glioblastoma Pancreatic ductal adenocarcinoma Multiple myeloma

Influence of parameters on the microstructure of a duplex stainless steel joint welded by a GMAW welding process

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Progress in Natural Science:Materials International 2022年第4期32卷 415-423页

作者： Sandra Chacón-Fernández antonio Portolés García gerardo Romaní Labanda Universidad Politécnica de Madrid Escuela Técnica Superior de Ingenieros Industriales UPM

Duplex stainless steels（DSSs） are widely used in industry for their desirable properties. Any fusion welding technique modifies the microstructure and, consequently, the properties of the material. This paper presents a parametric study of the variables that determine the energy contribution（current, voltage and welding speed） and the structural modifications produced during gas metal arc welding. The analysis comprises metallographic study,phase balance, dimensioning of the weld beads and tensile and hardness tests. The influence of the variables studied on the thermal cycles obtained（temperatures reached and cooling rate） was determined by using a finite element model. The results showed that, in addition to the indicated parameters, the parameter power transfer per volume（W/m3） and the geometry in the bead must be controlled due to their influence on the heat flow distribution and phase balance.

关键词： Welding Heat input GMAW Duplex stainless steels (DSS) Finite element model (FEM)

IgA Nephropathy: Are We Doing Enough?

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Open Journal of Nephrology 2023年第2期13卷 116-125页

作者： Jose Lucas Daza Yaroslad de la Cruz Luis Puello gerardo Gutierrez Alexander Ariza antonio Vasquez Orlando Ariza Department of Internal Medicine Nephrology University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine Hematology University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine Cardiology University of Buenos Aires Buenos Aires Argentina

Immunoglobulin A nephropathy (IgAN) was first identified and described as a disease by Berger and Hinglais in 1968. It is the most common primary glomerulopathy worldwide [1], most prevalent in East Asians and Caucasians and rare in black individuals. There are four key elements that contribute to IgAN, which determine the severity, course, and prognosis of the disease: circulating IgA immunocomplexes that favor mesangial deposition, the efficiency of the reticuloendothelial system, mesangial cell affinity and reaction to mesangial accumulation of poorly glycosylated IgA1, and the renal tendency to glomerulosclerosis and interstitial fibrosis. Clinical manifestations among patients with IgAN include hematuria, approximately 40% to 50% of cases present with one or more episodes of hematuria, usually preceded by upper respiratory tract infections. Between 30% and 40% present with hematuria and non-nephrotic range proteinuria that may be associated with arterial hypertension and impaired renal function. The TESTING study reveal a significant decrease in outcomes such as the risk of a 40% decrease in glomerular filtration rate or the need for renal replacement therapy in the group treated with steroids. The decrease in renal function compared to the group treated in the previously mentioned STOP-IgAN trial was 4 times less than in the TESTING study. Are we doing enough? Obviously, more trials are required with the use of adequate nephroprotection measures. We present 3 patients with a diagnosis of IgA nephropathy who attend the follow-up consultation and voluntarily decide to take part in the review.

关键词： Immunoglobulin A Nephropathy (IgAN) Inhibition of the Renin-Angiotensin System (ACEI/ARA II) End-Stage Renal Disease (ESRD)

Can Peripheral Venous Gases Replace Arterial Gases in a Patient with Chronic Kidney Disease?

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Open Journal of Nephrology 2023年第2期13卷 150-160页

作者： Jose Lucas Daza Yaroslad de la Cruz gerardo Gutierrez Luis Puello Victor Aldana antonio Vasquez Orlando Ariza Alexander Ariza Andres Cardenas Department of Internal Medicine Nephrology University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine Cardiology and Epidemiology School of Medicine Universidad de Los Andes Bogotá Colombia Department of Internal Medicine University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine Cardiology University of Buenos Aires Buenos Aires Argentina Department of Internal Medicine Hematology University of Buenos Aires Buenos Aires Argentina Department of General Medicine University Cooperativa Santa MartaColombia

Introduction: Metabolic acidosis (MA) is a frequent alteration in chronic kidney disease (CKD) that is associated with numerous complications, which is why its correction is recommended. Oral sodium bicarbonate is currently the treatment of choice. Objective: The objective is to determine if venous bicarbonate is equal to arterial bicarbonate in the follow-up of a patient with chronic kidney disease. Materials Methods: Single-center Cross-sectional studies in a cohort of adult patients with stage 4 - 5 CKD. Samples were taken between January 2022 and January 2023, in a Clinic in the city of Ibague/ Colombia obtained from the radial artery. The inclusion criteria were: not being treated with alkaline at the time of inclusion. Results: A total of 71 patients were included, 73.2% male (52) and 26.8% female (19), with different stages: stage 3 with 5.6% (4), stage 4 with 60.6% (43), stage 5 with 33.8% (23). 66.2% were diabetic, 88.7% had arterial hypertension, and 15.5% of the patients presented hematoma as a complication and pain associated with arterial puncture. The result of mean venous bicarbonate was 18.8 with a standard deviation of 2.3, arterial bicarbonate a mean of 19.4 with a standard deviation of 2.1 with a value of P 0.46, venous pH with a mean of 7.37 with a standard deviation of 0.48 and a mean arterial pH of 7.38 with a standard deviation of 0.48 with a P value of 0.01. Values of venous bicarbonate compared to arterial bicarbonate showed no statistically significant difference in patients with chronic kidney disease, but there were more complications such as hematoma and pain in patients in the arterial puncture cohort, because of this result venous bicarbonate corresponds to arterial bicarbonate, but has less risk of complications associated with the procedure. Conclusion: Metabolic acidosis is a frequent alteration in advanced chronic kidney disease, these results showed that the values of arterial and venous bicarbonate have no statistically significa

关键词： MA (Metabolic Acidosis) CKD (Chronic Kidney Disease) GFR (Glomerular Filtration Rate)

Intestinal amyloidosis:Two cases with different patterns of clinical and imaging presentation

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World Journal of Gastroenterology 2010年第20期16卷 2566-2570页

作者： Pier Paolo Mainenti Sabrina Segreto Marcello Mancini antonio Rispo Immacolata Cozzolino Stefania Masone Ciro Roberto Rinaldi gerardo Nardone Marco Salvatore IBB CNR NaplesVia Pansini 580131NaplesItaly Department of Biomorphological and Functional Sciences Section of RadiologyUniversity of Naples"Federico II"Via Pansini 580131NaplesItaly Department of Gastro-enterology University of Naples"Federico II"Via Pansini 580131NaplesItaly Department of Biomorphological and Functional Sciences Section of PathologyUniversity of Naples "Federico II"Via Pansini 580131NaplesItaly Department of General Surgery Geriatry and EndoscopyUniversity of Naples"Federico II"Via Pansini 580131NaplesItaly Department of Biotechnology Haema-tology UnitUniversity of Naples"Federico II"Via Pansini 580131NaplesItaly

The involvement of the small bowel in systemic forms of amyloidosis may be diffuse or very rarely *** cases of focal amyloidomas of the duodenum and jejunum without extraintestinal manifestations have been *** focal amyloidomas consisted of extensive amyloid infiltration of the entire intestinal wall *** barium studies,ultrasound and computed tomography(CT)patterns of diffuse small bowel amyloidosis have been described:the signs are non-specific and may include small-bowel dilatation,symmetric bowel wall thickening,mesenteric infiltration,and mesenteric *** data are available about the positron emission tomography (PET)/CT and magnetic resonance imaging(MRI)patterns of intestinal *** report two cases of small bowel amyloidosis:the former characterized by focal deposition of amyloid proteins exclusively within blood vessel walls of the terminal ileum,the latter characterized by diffuse intestinal involvement observed on MRI and PET/CT studies.

关键词： Amyloidosis Small bowel Positron emission tomography/computed tomography Magnetic resonance imaging Computed tomography

Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients

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World Journal of Gastroenterology 2009年第38期15卷 4781-4787页

作者： antonio Diaz-Sanchez Oscar Nuez-Martinez Cecilia Gonzalez-Asanza Ana Matilla Beatriz Merino Diego Rincon Inmaculada Beceiro Maria Vega Catalina Magdalena Salcedo Rafael Baares gerardo Clemente Liver Unit-CIBEREHD.Hospital General Universitario Gregorio Maraón Madrid 28007Spain Gastroenterology Unit Hospital Infanta Leonor Gastroenterology Unit Hospital Infanta Sofia Department of Gastroenterology Hospital Universitario Príncipe de Asturias

AIM： To assess the prevalence of portal hypertension （PH） related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH. METHODS： Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient （HVPG）. RESULTS： Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis wasalcoholism （45.5%）. Portal hypertensive colopathy （PHC） was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients （adenomatous type 65.2%）. One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices （GEV）, and 27.5% of patients with GEV presented with colopathy （P = 0.12）. A relationship between higher values of HVPG and presence of colopathy was observed （19.9：1：6.2 mmHg vs 16.8 ± 5.4 mmHg, P = 0.045）, but not with the grade of colopathy （P = 0.13）. Preneoplastic polyps and neoplasm （P = 0.02） and spontaneous bacterial peritonitis （P = 0.006） were more prevalent in patients with colopathy. We did not observe any association between previous β-blocker therapy and the presence of colorectal portal hypertensive vasculopathy. CONCLUSION： PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.

关键词： Liver cirrhosis Portal hypertension Polyps Colopathy Liver transplantation

Effects of Supplementation with Increasing Levels of Energy Concentrate on the Productive Response and Ruminal Digestion of Dairy Cows Grazing Lucerne Pasture

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Agricultural Sciences 2018年第11期9卷 1487-1505页

作者： Eloy Eduardo Salado Gustavo Bretschneider Alejandra Cuatrin gerardo antonio Gagliostro Area de Investigación en Producción Animal Instituto Nacional de Tecnología Agropecuaria (INTA) Rafaela Argentina Agencia de Extensión Rural Necochea Instituto Nacional de Tecnología Agropecuaria (INTA) Necochea Argentin Area de Investigación en Producción Animal Instituto Nacional de Tecnología Agropecuaria (INTA) Balcarce Argentina

The aim of the study was to determine the effect of three levels of energy concentrate intake on dry matter (DM) and energy intake, milk yield and composition, rumen environment and pasture neutral detergent fiber (NDF) digestion. Twelve Holstein multiparous cows in early lactation (69.0 ± 5 days postpartum) producing 32.8 (±4.0) kg milk were assigned to three treatments at (kg/cow day) 3.5 (T3.5), 7.0 (T7.0) and 10.5 (T10.5) kg concentrate in a 3 × 3 Latin Square design. Parameters of ruminal environment and neutral detergent fiber (NDF) digestion were obtained using 3 additional rumen cannulated cows. Concentrate was composed (as fed) by corn grain (68%), soybean meal (22%), wheat bran (8%) and a vitamin-mineral premix including monensin and thoroughly consumed. Yields (kg/cow day-1) of milk, 4% fat corrected milk (4% FCM 4%) and energy corrected milk (ECM) resulted higher (p p -1 without effects on yield of milk fat. Concentrations (g/100 g) of milk fat (3.19), protein (2.97), total solids (11.75), non-fat solids (8.60) and casein (2.40) did not differ. Milk lactose content (g/100 g) was linearly increased (p p p p p < 0.05) in T3.5 due to the increase in acetate and butyrate while the acetate: Propionate ratio remained unchanged. Pasture NDF digestion was affected as concentrate intake increased. To increase milk protein yield and reduce concentrations of N-NH3 in rumen and milk, feeding an energy concentrate at 41% of total DM intake resulted an effective tool.

关键词： Dairy Cows Concentrate Milk Yield Ruminal Digestion

Branching patterns of the left portal vein and consequent implications in liver surgery:The left anterior sector

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 399-402页

作者： Mattia Garancini Mauro Alessandro Scotti Luca Gianotti antonio Rovere Fabio Uggeri Marco Braga Fabrizio Romano Unit of Hepatobiliary Pancreatic Surgery Department of General Surgery 1ASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly Unit of Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 3320900 MonzaMBItaly

To the Editor: There are still some open issues about the systematization of the knowledge of the branching of the left portal vein(LPV) and the division in anatomo-functional units within the left liver. The first controversial topic concerns the division of S4 in subsegments. The Brisbane 20 0 0 system of Nomenclature of Hepatic Anatomy and Resections(B20 0 0) [1] does not mention such subdivision, but in literature this is still a matter of discussion.

关键词： branching portal discussion