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Complete spontaneous regression of giant focal nodular hyperplasia of the liver: Magnetic resonance imaging evaluation with hepatobiliary contrast media

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World Journal of Gastroenterology 2016年第47期22卷 10461-10464页

作者： giuseppe mamone Settimo Caruso Kelvin Cortis Roberto Miraglia Department of Diagnostic and Therapeutic Services IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies) Medical Imaging Department Mater Dei Hospital

Focal nodular hyperplasia(FNH) of the liver is a benign lesion occurring in 0.6%-3% of the general population that probably reflects a local hyperplastic response of hepatocytes to a vascular abnormality. Most lesions are diagnosed incidentally and the natural history of the disease remains largely unknown. It has been shown that most FNH remain stable, or even regress, over a long follow-up period. We present a patient with FNH of the liver who was followed up for 7 years. A 26-yearold woman with a 5-year history of oral contraceptive use was referred to our hospital in February 2005 for further examination of a liver tumour. The diagnosis of FNH was made using magnetic resonance(MR) imaging with hepatospecific contrast media; this technique allows a correct diagnosis, in particular distinguishing FNH from hepatic adenoma, avoiding an invasive procedure such as the lesion biopsy. After 7-year from the diagnosis, we observed the complete spontaneous regression of the lesion by enhanced MR scanning. In this patient, discontinuation of oral contraceptive use and two childbirths may have influenced the natural history of FNH. To our knowledge, in the English literature there is no report illustrating a complete regression of giant FNH but only studies of decreasing in size. The present case suggests that a young patient with giant FNH should be managed conservatively rather than by resection, because FNH has the potential for spontaneous regression.

关键词： Focal nodular hyperplasia Regression Magnetic resonance Oral contraceptives Pregnancy

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Multidisciplinary imaging of liver hydatidosis

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World Journal of Gastroenterology 2012年第13期18卷 1438-1447页

作者： Gianluca Marrone Francesca Crino' Settimo Caruso giuseppe mamone Vincenzo Carollo Mariapina Milazzo Salvatore Gruttadauria Angelo Luca Bruno Gridelli Department of Diagnostic and Interventional Radiology Mediterranean Institute for Transplantation and Advanced Specialized TherapiesUniversity of Pittsburgh Medical Center Italy90127 PalermoItaly Department of Transplantation Surgery Mediterranean Institute for Transplantation and Advanced Specialized TherapiesUniversity of Pittsburgh Medical Center Italy90127 PalermoItaly

Liver hydatidosis is a parasitic endemic disease affecting extensive areas in our planet, a significant stigma within medicine to manage because of its incidence, possible complications, and diagnostic involvements. The diagnosis of liver hydatidosis should be as fast as possible because of the relevant complications that may arise with disease progression, involving multiple organs and neighboring structures causing disruption, migration, contamination. The aim of this essay is to illustrate the role of imaging as ultrasonography （US）, multi detector row computed tomography, and magnetic resonance imaging （MRI） in the evaluation of liver hydatidosis： the diagnosis, the assessment of extension, the identification of possible complications and the monitoring the response to therapy. US is the screening method of choice. Computed tomography （CT） is indi-cated in cases in which US is inadequate and has high sensitivity and specificity for calcified hydatid cysts. Magnetic resonance is the best imaging procedure to demonstrate a cystic component and to show a biliary tree involvement. Diagnostic tests such as CT and MRI are mandatory in liver hydatidosis because they allow thorough knowledge regarding lesion size, location, and relations to intrahepatic vascular and biliary structures, providing useful information for effective treatment and decrease in post-operative morbidity. Hydatid disease is classified into four types on the basis of their radiologic appearance.

关键词： Liver hydatidosis Hepatic cyst Daughtercysts Calcified cyst Pericyst

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Interventional radiology procedures in adult patients who underwent liver transplantation

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World Journal of Gastroenterology 2009年第6期15卷 684-693页

作者： Roberto Miraglia Luigi Maruzzelli Settimo Caruso Mariapina Milazzo Gianluca Marrone giuseppe mamone Vincenzo Carollo Salvatore Gruttadauria Angelo Luca Bruno Gridelli Department of Diagnostic and Interventional Radiology Mediterranean Institute for Transplantation and Advanced Specialized Therapies(IsMeTT) University of Pittsburgh Medical CenterVia Tricomi 1 Palermo 90127Italy Department of Transplantation Surgery Mediterranean Institute for Transplantation and Advanced Specialized Therapies(IsMeTT) University of Pittsburgh Medical CenterVia Tricomi 1 Palermo 90127Italy

Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or *** aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

关键词： Liver transplantation Interventional radiology Complication Review Liver

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Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第21期13卷 2952-2955页

作者： Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone giuseppe mamone Giovanni Vizzini Angelo Luca Bruno Gridelli Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (IsMeTT).University of Pittsburgh Medical Center Italy

AIM:To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS:A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrastenhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2,infused over 30 min using a peristaltic pump,and followed by Lipiodol and Gelfoam embolization. RESULTS:Patients characteristics were:mean age,62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size,3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm,n = 51; 2.1-3.0 cm,n = 35; 3.1-4.0 cm,n = 29; 4.1-5.0 cm,n = 22; 5.1-6.0 cm,n = 11; and > 6.0 cm,n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%),massive (90%-99%) necrosis in 16 patients (10%),partial (50%-89%) necrosis in 18 patients (11%) and poor ( 6.0 cm,respectively. Kaplan-Mayer survival at 24-mo was 88%,68%,59%,59%,45%,and 53% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. CONCLUSION:Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm,TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embo

关键词： Transcatheter embolization/chemoembolization Hepatocellular carcinoma

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Predictive factors of tumor response to trans-catheter treatment in cirrhotic patients with hepatocellular carcinoma:A multivariate analysis of pre-treatment findings

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World Journal of Gastroenterology 2007年第45期13卷 6022-6026页

作者： Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone giuseppe mamone Giovanni Vizzini Angelo Luca Bruno Gridelli Department of Radiology Mediterranean Institute for Transplantation and A dvanced Specialized Therapies(IsMeTT)University of Pittsburgh Medical Center Palermo90127Italy Department of Hepatology Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center Palermo 90127 Italy Department of Transplantation Surgery Mediterranean Institute for Transplantation and AdvancedSpecialized Therapies (IsMeTT) University of Pittsburgh MedicalCenter Palermo 90127 Italy

AIM： To elucidate the pre-treatment clinical and imaging findings affecting the tumor response to the transcatheter treatment of unresectable hepatocellular carcinoma （HCC）. METHODS： Two hundred cirrhotic patients with HCC received a total of 425 transcatheter treatments. The tumor response was evaluated by helical CT and a massive necrosis （MN） was defined as a necrosis 〉 90%. Twenty-five clinical and imaging variables were analyzed： uninodular/multinodular HCC, unilobar/bilobar, tumor capsula, hypervascular lesion, portal vein thrombosis, portal hypertension, ascites, platelets count, aspartate transaminases/alanine transaminases （AST/ALT）, alfa- fetoprotein （AFP）〉 100, AFP 〉 400, serum creatinine, virus hepatitis C （VHC） cirrhosis, performance status, age, Okuda stage, ChUd-Pugg stage, sex, CLIP （Cancer of the Liver Italian Program） score, serum bilirubin, constitutional syndrome, serum albumine, prothrombin activity, BCLC （Barcelona Clinic Liver Cancer） stage. Prognostic factors of response were subjected to univariate analysis and thereafter, when significant, to the multivariate analyses. RESULTS： On imaging analysis, complete response wasobtained in 60 （30%） patients, necrosis 〉 90% in 38 （19%） patients, necrosis 〉 50% in 44 （22%） patients, and necrosis 〈 50% in 58 （29%） patients. Ninety-eight （49%） of the 200 patients were considered to have a MN. In univariate analysis, significant variables （P 〈 0.01） were： uninodular tumor, unilobar, tumor size 2-6 cm, CLIP score 〈 2, absence of constitutional syndrome, and BCLC stage 〈 2. In a multivariate analysis, the variables reaching statistical significance were： presence of tumor capsule （P 〈 0.0001）, tumor size 2-6 cm （P 〈 0.03）, CLIP score 〈 2 （P 〈 0.006）, and absence of constitutional syndrome （P 〈 0.03）. Kaplan-Mayer cumulative survival at 12 mo was 80% at 24 mo was 56%. MN was associated with a longer survival （P 〈 0.0001）. CONCLUSION： MN after transcatheter treatment is more common in the presence of tumor

关键词： Hepatocellular carcinoma Trans-catheterembolization/chemoembolization Tumor response

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Experimental Characterization of a Binary Actuated Parallel Manipulator

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Chinese Journal of Mechanical Engineering 2016年第3期29卷 445-453页

作者： CARBONE giuseppe Department of Engineering and Mathematics Sheffield Hallam UniversitySheffieldUnited Kingdom Laboratory of Robotics and Mechatronics University of Cassino and South LatiumCassino(Fr)Italy

This paper describes the BAPAMAN（Binary Actuated Parallel MANipulator） series of parallel manipulators that has been conceived at Laboratory of Robotics and Mechatronics（LARM）. Basic common characteristics of BAPAMAN series are described. In particular, it is outlined the use of a reduced number of active degrees of freedom, the use of design solutions with flexural joints and Shape Memory Alloy（SMA） actuators for achieving miniaturization, cost reduction and easy operation features. Given the peculiarities of BAPAMAN architecture, specific experimental tests have been proposed and carried out with the aim to validate the proposed design and to evaluate the practical operation performance and the characteristics of a built prototype, in particular, in terms of operation and workspace characteristics.

关键词： parallel manipulators binary actuation experimental characterization

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Arbitrary full-state hybrid projective synchronization for chaotic discrete-time systems via a scalar signal

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Chinese Physics B 2012年第6期21卷 94-99页

作者： giuseppe Grassi Dipartimento Ingegneria Innovazione Universitàdel Salento-73100 Lecce-Italy

In this paper we present a new projective synchronization scheme, where two chaotic （hyperchaotic） discrete-time systems synchronize for any arbitrary scaling matrix. Specifically, each drive system state synchronizes with a linear combination of response system states. The proposed observer-based approach presents some useful features： i） it enables exact synchronization to be achieved in finite time （i.e., dead-beat synchronization）; ii） it exploits a scalar synchronizing signal; iii） it can be applied to a wide class of discrete-time chaotic （hyperchaotic） systems; iv） it includes, as a particular case, most of the synchronization types defined so far. An example is reported, which shows in detail that exact synchronization is effectively achieved in finite time, using a scalar synchronizing signal only, for any arbitrary scaling matrix.

关键词： chaos synchronization full-state hybrid projective synchronization observer-based syn-chronization chaotic discrete-time systems dead beat control attractor scaling

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Fuzzy-entropy based robust optimization criteria for tuned mass dampers

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Earthquake Engineering and Engineering Vibration 2010年第2期9卷 285-294页

作者： giuseppe Carlo Marano giuseppe Quaranta Sara Sgobba Department of Environmental Engineering and Sustainable Development Technical University of Bari Department of Structural Engineering and Geotechnics University of Rome "La Sapienza" Faculty of Engineering International University UNINETTUNO

Tuned mass dampers (TMD) are well known as one of the most widely adopted devices in vibration control passive strategies. In the past few decades,many methods have been developed to find the optimal parameters of a TMD installed on a structure and subjected to a random base excitation process,but most of them are usually based on an implicit assumption that all of the structural parameters are deterministic. However,in many real cases this simplification is unacceptable,so robust optimal design criteria becomes aviable alternative to better support engineers in the design process. In Robust Design Optimization (RDO) approaches,indeed the solution must be able to not only minimize the performance but also to limitits variation induced by uncertainty. Most of the currently available RDO methods are based on a probabilistic description of the model uncertainty,even if in many cases they are not able to explicitly include the influence of all the possible sources of uncertainties. Therefore,in this study,a fuzzy version of the robust TMD design optimization problem is proposed. The consistency of the fuzzy approach is studied with respect to the available non-probabilistic formulations reported in the literature and an application to an example of a robust design of a linear TMD subjected to base random vibrations in the presence of fuzzy uncertainties. The results show that the proposed fuzzy-based approach is able to give a set of optimal solutions both in terms of structural efficiency and sensitivity to mechanical and environmental uncertainties.

关键词： tuned mass damper random vibration robust design fuzzy variable expected value fuzzy entropy

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Novel four-wing and eight-wing attractors using coupled chaotic Lorenz systems

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Chinese Physics B 2008年第9期17卷 3247-3251页

作者： giuseppe Grassi Dipartimento di Ingegneria dell’Innovazione Università del Salento

This paper presents the problem of generating four-wing （eight-wing） chaotic attractors. The adopted method consists in suitably coupling two （three） identical Lorenz systems. In analogy with the original Lorenz system, where the two wings of the butterfly attractor are located around the two equilibria with the unstable pair of complex-conjugate eigenvalues, this paper shows that the four wings （eight wings） of these novel attractors axe located around the four （eight） equilibria with two （three） pairs of unstable complex-conjugate eigenvalues.

关键词： chaotic attractors multi-wing attractor coupled Lorenz systems dynamical behaviours

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Reliability based multiobjective optimization for design of structures subject to random vibrations

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Journal of Zhejiang University-Science A(Applied Physics & Engineering) 2008年第1期9卷 15-25页

作者： giuseppe Carlo MARANO Department of Environmental Engineering and Sustainable Development Technical University of Bari viale del Turismo 10-74100 Taranto Italy

Based on a multiobjective approach whose objective function (OF) vector collects stochastic reliability performance and structural cost indices, a structural optimization criterion for mechanical systems subject to random vibrations is presented for supporting engineer’s design. This criterion differs from the most commonly used conventional optimum design criterion for random vibrating structure, which is based on minimizing displacement or acceleration variance of main structure responses, without considering explicitly required performances against failure. The proposed criterion can properly take into account the design-reliability required performances, and it becomes a more efficient support for structural engineering decision making. The multiobjective optimum (MOO) design of a tuned mass damper (TMD) has been developed in a typical seismic design problem, to control structural vibration induced on a multi-storey building structure excited by nonstationary base acceleration random process. A numerical example for a three-storey building is developed and a sensitivity analysis is carried out. The results are shown in a useful manner for TMD design decision support.

关键词： Structural optimization Multiobjective optimization (MOO) Random vibration Tuned mass damper (TMD)

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