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Patatin-like phospholipase domain containing-3 gene I148M polymorphism, steatosis, and liver damage in hereditary hemochromatosis

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World Journal of Gastroenterology 2012年第22期18卷 2813-2820页

作者： luca Valenti paolo Maggioni Alberto Piperno Raffaela Rametta Sara Pelucchi Raffaella Mariani Paola Dongiovanni Anna Ludovica Fracanzani Silvia Fargion Università degli Studi di Milano Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico 20122 Milano Italy Università di Milano Bicocca Ospedale San Gerardo Monza 20090 Monza MI Italy

AIM： To investigate whether the patatin-/ike phosph- olipase domain containing-3 gene （PNPLA3） I148M polymorphism is associated with steatosis, fibrosis stage, and cirrhosis in hereditary hemochromatosis （HH）. METHODS： We studied 174 consecutive unrelated homozygous for the C282Y HFE mutation of HH （C282Y＋/＋ HH） patients from Northern Italy, for whom the presence of cirrhosis could be determined based on histological or clinical criteria, without excessive alcohol intake （〈 30/20 g/d in males or females） or hepatitis B virus and hepatitis C virus viral hepatitis. Steatosis was evaluated in 123 patients by histology （n = 100） or ul- trasound （n = 23）. The PNPLA3 rs738409 single nucle- otide polymorphism, encoding for the p.148M protein variant, was genotyped by a Taqman assay （assay on demand, Applied Biosystems）. The association of the PNPLA3 I148M protein variant （p.I148M） with steatosis, fibrosis stage, and cirrhosis was evaluated by logistic regression analysis. RESULTS： PNPLA3 genotype was not associated with metabolic parameters, including body mass index （BMI）, the presence of diabetes, and lipid levels, but the pres- ence of the p.148M variant at risk was independently associated with steatosis [odds ratio （OR） 1.84 per p.148M allele, 95% confidence interval （CI）： 1.05-3.31; P = 0.037], independently of BMI and alanine amino- transaminase （ALT） levels. The p.148M variant was also associated with higher aspartate aminotransferase （P = 0.0014） and ALT levels （P = 0.017） at diagnosis, independently of BMI and the severity of iron overload. In patients with liver biopsy, the 148M variant was independently associated with the severity （stage） of fibrosis （estimated coefficient 0.56 ± 0.27, P = 0.041）. In the overall series of patients, the p.148M variant was associated with cirrhosis in lean （P = 0.049）, but not in overweight patients （P = not significant）. At logistic regression analysis, cirrhosis was associated with BMI 〉~ 25 （OR 1.82, 95% CI： 1.02-3.55）, ferri

关键词： Fatty liver Fibrosis Hemochromatosis HFEprotein Iron overload Patatin-like phospholipase domaincontaining-3 gene Steatosis

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Pesticide Residue Control in the Years 1983-1985

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Biomedical and Environmental Sciences 1989年第3期2卷 287-294页

作者： IVANO CAMONI ALFONSO di MUCCIO MARIA SANDRA BELLISAI MARIO BERSACCHI paolo CITTI Istituto Superiore di Sanita Lab. Tossicologia Applicata Viale Regina Elena Rome Italy Ministero

Levels of organochlorinated, organophosphate, dithiocarbamic, benzimidazolic, and phthalimidic compounds, as well as some other pesticide residues obtained from Regional Laboratories in the years 1983-1985, were assembled and presented as a part of a study aimed at evaluating food contamination. Approximately 2000 samples of vegetables, fruits, cereals, and food of animal origin were analyzed by local laboratories during the years 1983, 1984, and 1985. Samples were randomly obtained from the market, at production levels, or sometimes at custom sites. Approximately 10,000 determinations of single compounds or classes of compounds were carried out. The analytical results are presented and compared with the Italian maximum residue limits. In the majority of the samples analyzed, either there were no residues or the residues were below the permitted level for the specific pesticide in each commodity. High levels of residues were present in a few cases, mainly with respect to some fungicides in fruits and vegetables and chlorinated compounds in some animal products. (c)1989 Academic Press, Inc.

关键词： Pesticide Residue Control in the Years 1983-1985

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How to choose the most appropriate technique for the single-stage treatment of cholecysto-choledocolithiasis?

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Gastroenterology Report 2019年第4期7卷 258-262,I0001,I0002页

作者： Aldo Bove paolo Panaccio Raffaella di Renzo Gino Palone Marco Ricciardiello Sara Ciuffreda Giuseppe Bongarzoni Department of Medicine Dentistry and BiotechnologyUniversity‘G.D’Annunzio’Via dei VestiniChietiItaly

Background:We utilized transcystic clearance and intra-operative papillotomy through a rendezvous technique for the treatment of *** goal of this study was to evaluate the reliability of pre-operative parameters to address the most suitable surgical ***:A total of 180 patients affected by calculi of the gallbladder and bile duct underwent the single-stage *** to several pre-operative parameters,141 patients had to supposedly undergo transcystic clearance of the bile duct,while 39 patients had to be treated with the rendezvous *** patients were treated with the sequential procedure:first,we tried the transcystic procedure and,if there was a failure,we used a rendezvous *** prospectively analysed each group based on a series of variables such as sex,age,operative time,success rate of proposed treatment,conversion rate,post-operative complications and hospital ***:Transcystic clearance was successful in 134 out of 141 patients(95.0%),while 2 patients needed to undergo a laparo-endoscopy procedure(failure).Thirty-five out of 39 patients(89.7%)obtained common bile-duct(CBD)clearance through the rendezvous technique,while 1 patient obtained clean-up through the simple transcystic procedure(failure).Five out of 141 patients with transcystic clearance and 3 out of 39 patients with the rendezvous technique underwent laparotomy CBD clearance with conversion rates of 3.5%and 7.7%,***-operative complications showed similar percentages for both ***,the surgical time turned out to be longer for the rendezvous ***:The one-stage procedure for the treatment of cholecysto-choledocolithiasis was possible in 94%of the cases utilizing a surgical technique selected according to the patient’s case *** pre-operative parameters,such as jaundice,CBD diameters and stone diameters,have certified their reliability as good predictors of the most suitable

关键词： Common bile-duct stone transcystic laparoscopic bile-duct clearance laparoscopic common bile-duct exploration rendezvous intra-operative endoscopic retrograde cholangiography

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Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series

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World Journal of Gastroenterology 2017年第45期23卷 8000-8007页

作者： Gian luca Baiocchi Sarah Molfino Carla Baronchelli Simone Giacopuzzi Daniele Marrelli paolo Morgagni Maria Bencivenga luca Saragoni Carla Vindigni Nazario Portolani Maristella Botticini Giovanni De Manzoni Department of Clinical and Experimental Sciences University of Brescia Department of Pathology Spedali Civili di Brescia 1st Department of General Surgery Borgo Trento HospitalUniversity of Verona Department of Human Pathology and Oncology Surgical OncologyUniversity of Siena Department of General Surgery Morgagni-Pierantoni Hospital Department of Pathology Morgagni-Pierantoni Hospital Department of Pathology Azienda Ospedaliera Universitaria Senese IGIER Università Bocconi

AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for *** The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up.

关键词： N0 gastric cancer Recurrence Prognostic factors Pathological analysis Lymphatic embolization Perineural infiltration p53 Ki67

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Sudden death in a captive meerkat(Suricata suricatta) with arterial medial and myocardial calcification

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Asian Pacific Journal of Tropical Biomedicine 2016年第4期6卷 357-359页

作者： Laura Bongiovann Nicola di Girolamo Leonardo Della Salda Marcella Massimi Mariarita Romanucci paolo Selleri Faculty of Veterinary Medicine University of Teramo Clinic for Exotic Animals Center of Veterinary Specialists

A 1-year-old male meerkat was found dead by the *** animal was clinically healthy and was regularly vaccinated for distemper *** revealed multifocal to confluent dry white areas in the myocardium,pneumonia and congestive *** the other organs,including gross vessels,were macroscopically *** heart showed histologically large,multifocal to confluent areas of mineralization of the myocardium and the wall of small coronary *** calcifications were also observed in the hepatic portal tracts and kidneys arteries of small/medium *** arterial lumen appeared narrowed and the wall thickened due to the calcification of the tunica *** veterinary medicine,arterial mineralization is regarded as a metastatic calcification,as the result of hypercalcemia and/or ***,today,the pathogenesis of medial artery calcification in humans seems to be the results of an active process resembling embryonic osteogenesis,rather than a mere passive process.

关键词： Meerkat Suricata suricatta Arterial calcification Myocardial calcification

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Practical Applications with Geosynthetic Mats Reinforced with Steel Wire Meshes to Prevent Embankment Damage by Burrowing Large Rodents and Beavers

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Journal of Civil Engineering and Architecture 2017年第1期11卷 8-15页

作者： paolo di Pietro Officine Maccaferri SPA Zola Predosa 40069 Italy

Recent studies show an increase in the population of beavers, nutria and other rodents in vast regions of central Europe over the last 15 years. Unfortunately, this caused in many instances considerable damage on large rivers along dykes and earthworks in the floodplain areas, leading to an increased risk of bank failures. However, most of these mammals belong to protected species. This work is aimed at showing positive experience in cooperation with universities, research institutes and environmental agencies regarding measures to permanently safeguard the banks using composite erosion control systems with polymer coated steel wire net （as flexible reinforcement component） and a geosynthetic （to promote vegetation growth）. The steel mesh component works as an effective long-term barrier against the intrusion of mammals, discouraging them from digging inside the core of the dyke. An analysis of the sensitive areas to be protected led also to definition of the characteristics of these interventions （length, shape, escape ways, population areas, etc.）. The study will present several additional benefits when using polymer steel nets along dykes, such as： high and durable erosion protection in overflow areas, promotion of fast and effective vegetation growth （increasing stability）, surface protection against ice impacts （in northern regions）, ease of installation, maintenance, ability to conform to irregular shapes of the slope. This work will also present the positive outcome of research studies along dykes in Germany, Austria and in Italy.

关键词： Beavers nutria polymer coated steel net dykes erosion control.

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Does protracted antiviral therapy impact on HCV-related liver cirrhosis progression?

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World Journal of Gastroenterology 2007年第36期13卷 4903-4908页

作者： Giovanni Tarantino Antonio Gentile Domenico Capone Vincenzo Basile Marianna Tarantino Matteo Nicola Dario di Minno Alberto Cuocolo paolo Conca Department of Clinical and Experimental Medicine Federico Ⅱ University Medical School of Naples Naples 80131 Italy Department of Biomorphological and Functional Sciences Pharmacology Section of Neuroscience Department Federico Ⅱ University Medical School of Naples Naples 80131 Italy

AIM: To study the outcomes of patients with compensated hepatitis C virus-related cirrhosis. METHODS: Twenty-four grade A5 and 11 grade A6 of Child-Pugh classification cirrhotic patients with active virus replication, treated for a mean period of 31.3 ± 5.1 mo with moderate doses of interferon-alpha and ribavirin, were compared to a cohort of 36 patients with similar characteristics, without antiviral treatment. Salivary caffeine concentration, a liver test of microsomal function, was determined at the starting and thrice in course of therapy after a mean period of 11 ± 1.6 mo, meanwhile the resistive index of splenic artery at ultra sound Doppler, an indirect index of portal hypertension, was only measured at the beginning and the end of study. RESULTS: Eight out of the 24 A5- (33.3%) and 5 out of the 11 A6- (45.45%) treated-cirrhotic patients showed a significant improvement in the total overnight salivary caffeine assessment. A reduction up to 20% of the resistive index of splenic artery was obtained in 3 out of the 8 A5- (37.5%) and in 2 out of the 5 A6- (40%) cirrhotic patients with an improved liver function, which showed a clear tendency to decrease at the end of therapy. The hepatitis C virus clearance was achieved in 3 out of the 24 (12.5%) A5- and 1 out of the 11 (0.091%) A6-patients after a median period of 8.5 mo combined therapy. In the cohort of non-treated cirrhotic patients, not only the considered parameters remained unchanged, but 3 patients (8.3%) had a worsening ofthe Child-Pugh score (P = 0.001).CONCLUSION: A prolonged antiviral therapy with moderate dosages of interferon-alpha and ribavirin shows a trend to stable liver function or to ameliorate the residual liver function, the entity of portal hypertension and the compensation status at acceptable costs.

关键词： Liver cirrhosis Hepatitis C virus infection Antiviral therapy

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Proton pump inhibitors in cirrhosis:Tradition or evidence based practice?

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World Journal of Gastroenterology 2008年第19期14卷 2980-2985页

作者： Francesca Lodato Francesco Azzaroli Maria di Girolamo Valentina Feletti paolo Cecinato Andrea Lisotti Davide Festi Enrico Roda Giuseppe Mazzella Department of Internal Medicine and Gastroenterology Gastroenterology UnitUniversity of Bologna

Proton Pump Inhibitors (PPI) are very effective in inhibiting acid secretion and are extensively used in many acid related diseases. They are also often used in patients with cirrhosis sometimes in the absence of a specific acid related disease, with the aim of preventing peptic complications in patients with variceal or hypertensive gastropathic bleeding receiving multidrug treatment. Contradicting reports support their use in cirrhosis and evidence of their efficacy in this condition is poor. Moreover there are convincing papers suggesting that acid secretion is reduced in patients with liver cirrhosis. With regard to Helicobacter pylori (H pylori) infection, its prevalence in patients with cirrhosis is largely variable among different studies, and it seems that H pylori eradication does not prevent gastro-duodenal ulcer formation and bleeding. With regard to the prevention and treatment of oesophageal complications after banding or sclerotherapy of oesophageal varices, there is little evidence for a protective role of PPI. Moreover, due to liver metabolism of PPI, the dose of most available PPIs should be reduced in cirrhotics. In conclusion, the use of this class of drugs seems more habit related than evidence- based eventually leading to an increase in health costs.

关键词： Proton pump inhibitors Cirrhosis H pylori Peptic ulcer CYP P450

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Robotic liver surgery is the optimal approach as bridge to transplantation

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World Journal of Hepatology 2017年第4期9卷 224-226页

作者： paolo Magistri Giuseppe Tarantino Roberto Ballarin Andrea Coratti Fabrizio di Benedetto Department of Medical and Surgical Sciences and Translational Medicine Sapienza - University of Rome Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit University of Modena and Reggio Emilia Department of Oncology Division of Oncological and Robotic General Surgery Careggi University Hospital

The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas(HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers. In particular, minimally invasive approach to the liver showed several advantages compared to the classical open procedure, in terms of:(1) the small impact on abdominal wall;(2) the gentle manipulation on the liver;(3) the limited surgical trauma; and(4) the respect of venous shunts. Therefore, more direct indications should be outlined also in the Barcelona Clinic Liver Cancer model. We believe that treatment of HCC in cirrhotic patients should be reserved to tertiary referral hepatobiliary centers, that should offer patient-tailored approaches to the liver disease, in order to provide the best care for each case, according to the individual comorbidities, risk factors, and personal quality of life expectations.

关键词： Hepatocellular carcinomas Liver transplant Robotic surgery Bridge to transplantation Da vinci Barcelona Clinic Liver Cancer Patient safety

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Major liver resections,perioperative issues and posthepatectomy liver failure:A comprehensive update for the anesthesiologist

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World Journal of Critical Care Medicine 2024年第2期13卷 49-71页

作者： Andrea De Gasperi Laura Petrò Ombretta Amici Ilenia Scaffidi Pietro Molinari Caterina Barbaglio Eva Cibelli Beatrice Penzo Elena Roselli Andrea Brunetti Maxim Neganov Alessandro Giacomoni paolo Aseni Elena Guffanti Former Head Anesthesia and Critical Care Service 2Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy AR1 Ospedale Papa Giovanni 23Bergamo 24100Italy Anesthesia and Critical Care Service 2 Grande Ospedale Metropolitano Niguarda AR2ASST GOM NiguardaMilan 20163Italy Anestesia e Terapia Intensiva Generale Istituto Clinico HumanitasRozzano 20089Italy Chirurgia Oncologica Miniinvasiva Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy dipartimento di Medicina d’Urgenza ed Emergenza Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilano 20163MIItaly

Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver *** support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved *** postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative ***,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or *** review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute Liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward *** a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.

关键词： Liver resection Chronic liver disease Preoperative assessment Vascular clamping Intraoperative hemodynamic monitoring Postoperative intensive care unit Posthepatectomy liver failure Artificial liver support

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