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Rethinking the Barcelona clinic liver cancer guidelines:Intermediate stage and Child-Pugh B patients are suitable for surgery?

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World Journal of Gastroenterology 2021年第21期27卷 2784-2794页

作者： Fabrizio romano marco Chiarelli Mattia Garancini Mauro Scotti Mauro Zago Gerardo Cioffi Matilde De Simone Ugo Cioffi Department of Surgery School of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy Emergency and Robotic Surgery A.Manzoni HospitalASST LeccoLecco 23900Italy Department of General Surgery San Gerardo HospitalMonza 20900Italy Department of Sciences and Technologies Universitàdegli Studi del Sannio di BeneventoBenevento 82100Italy Department of Surgery University of MilanMilano 20122Italy

According to Barcelona Clinic Liver Cancer recommendations,intermediate stage hepatocellular carcinomas(stage B)are excluded from liver resection and are referred to palliative ***,Child-Pugh B patients are not usually candidates for liver ***,many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection,maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver *** studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification,and this treatment gives good results in the setting of multinodular,large tumors in patients with portal hypertension and/or Child-Pugh B *** this review we explore this controversial topic,and we show through the literature analysis how liver resection may improve the short-and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma ***,other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection.

关键词： Liver surgery Hepatocellular carcinoma Barcelona liver clinic cancer Child B Intermediate stage

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Microscopic tumor foci in axillary lymph nodes may reveal the recurrence dynamics of breast cancer

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Cancer Communications 2019年第1期39卷 334-337页

作者： romano Demicheli marco Fornili Patrizia Querzoli Massimo Pedriali Saverio Alberti Christine Desmedt Elia Biganzoli Unit of Medical Statistics Biometry and BioinformaticsCampus Cascina RosaFondazione IRCCS Istituto Nazionale TumoriLaboratory of Medical Statistics and Epidemiology“Giulio A.Maccacaro”Department of Clinical Sciences and Community HealthUniversity of MilanVia Vanzetti 520133 MilanItaly Laboratory of Medical Statistics and Epidemiology “Giulio A.Maccacaro”Department of Clinical Sciences and Community HealthUniversity of MilanVia Vanzetti 520133 MilanItaly Section of Surgical Pathology Department of MorphologySurgical and Experimental MedicineUniversity of Ferrara44121 FerraraItaly Operative Unit of Surgical Pathology Azienda Ospedaliera-UniversitariaUniversity of Ferrara44121 FerraraItaly Section of Medical Genetics Department of Biomedical and Odontoiatric SciencesMorphological and Functional ImagingUniversity of Messina98125 MessinaItaly Laboratory for Translational Breast Cancer Research Department of OncologyKatholieke Universiteit LeuvenHerestraat 493000 LouvainBelgium

Dear Editor,In early breast cancer,the prognostic value of the num-ber of macroscopically metastasized axillary nodes has been recognized in earlier reports[1].However,the impact of microscopic tumour cell deposits on the sur-vival outcome of early breast cancer patients is still debated[2].This issue has gained increasing attention since the implementation of sentinel node biopsy in axil-lary node staging for tailoring breast cancer treatments,and the status of the single resected node would deter-mine the clinical decision of whether or not to perform the axillary lymph node dissection[3].Moreover,this issue raises more questions on whether to administer primary or adjuvant systemic treatment for patients with lymph nodes bearing isolated tumour cells(pN0[i+])or micrometastases(pN1mi).Despite the wide debate on the clinical treatment dilemma encountered by early breast cancer patients with microscopic tumour cell deposits,the biology underlying different pathologi-cal presentations at microscopic level(pN0,pN0[i+],pN1mi)and the disease outcomes remain poorly *** an attempt to shed some light on this topic,we have analyzed,in the context of dormancy-based metastasis development model[4],early breast cancer patients con-ventionally classified as pN0(tumour foci with largest diameter≤2 mm)[5]by systematically reassessing their tumor recurrence dynamics following primary tumour resection at a single institution.

关键词： lymph dynamics gained

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Diet in neurogenic bowel management:A viewpoint on spinal cord injury

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World Journal of Gastroenterology 2020年第20期26卷 2479-2497页

作者： marco Bernardi Anna Lucia Fedullo Elisabetta Bernardi Diego Munzi Ilaria Peluso Jonathan Myers Florigio romano Lista Tommaso Sciarra Department of Physiology and Pharmacology"V.Erspamer" Sapienza University of RomeRome 00185Italy Italian Paralympic Committee Rome 00191Italy Federazione Italiana Pallacanestro In Carrozzina(FIPIC) Rome 00188Italy Department of Biosciences Biotechnologies and BiopharmaceuticsUniversity of Bari"Aldo Moro"Bari 70121Italy Joint Veteran Center Scientific DepartmentArmy Medical CenterRome 00184Italy Research Centre for Food and Nutrition Council for Agricultural Research and Economics(CREA-AN)Rome 00178Italy VA Palo Alto Health Care System and Stanford University Cardiology DivisionPalo AltoCA 94025United States Scientific Department Army Medical CenterRome 00184Italy

The aim of this review is to offer dietary advice for individuals with spinal cord injury(SCI)and neurogenic bowel *** this in mind,we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy,autonomic dysreflexia and neurogenic *** addition,SCI is often associated with a sedentary lifestyle,which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation,including cardiovascular and chronic kidney *** Mediterranean diet,along with exercise and dietary supplements,has been suggested as an anti-inflammatory intervention in individuals with ***,individuals with chronic SCI have a daily intake of whole fruit,vegetables and whole grains lower than the recommended dietary allowance for the general *** studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake;therefore,this finding could explain the low consumption of plant *** consumption of fibre induces dysbiosis,which is associated with bothendotoxemia and *** can be reduced by exercise and diet in individuals with ***,to summarize our viewpoint,we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise *** guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI,chronic kidney diseases,chronic pain and irritable bowel *** also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength,flexibility and cardiorespiratory fitness and to obtain cardiometabolic ***,dietary advice for Paralympic athletes is suggested.

关键词： Neurogenic bowel dysfunction Body composition Mediterranean diet Food–drug interactions Microbiota Paralympic athletes

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Yolk vitamin E positively affects prenatal growth but not oxidative status in yellow-legged gull embryos

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Current Zoology 2018年第3期64卷 285-292页

作者： marco PAROLINI Cristina Daniela POSSENTI Filiz KARADAS Graziano COLOMBO Maria romano Manuela CAPRIOLI Isabella DALLE-DONNE Diego RUBOLINI Aldo MILZANI Nicola SAINO Department of Environmental Science and Policy University of Milan via Celoria 26 20133 Milano Italy Department of Animal Science University of Yuzuncu Yil 65090 Van Turkey Department of Biosciences University of Milan via Celoria 26 20133 Milan Italy

Parental effects occur whenever the phenotype of parents or the environment that they experience influences the phenotype and fitness of their offspring, In birds, parental effects are often mediated by the size and biochemical quality of the eggs in terms of maternally transferred components. Exogenous antioxidants are key egg components that accomplish crucial physiological functions during early life. Among these, vitamin E plays a vital role during prenatal development when the intense metabolism accompanying rapid embryo growth results in overproduction of pro-oxidant molecules. Studies of captive birds have demonstrated the positive effect of vitamin E supplementation on diverse phenotypic traits of hatchling and adult individuals, but its effects on embryo phenotype has never been investigated neither in captivity nor under a natural selection regime. In the present study, we experimentally tested the effect of the in ovo supplementation of vitamin E on morphological traits and oxidative status of yellow-legged gull （Larus michahellis） embryos. The supplementation of vitamin E promoted somatic growth in embryos soon before hatching, but did not affect their oxidative status. Our results suggest that maternally transferred vitamin E concentrations are optimized to prevent imbalances of oxidative status and the consequent raise of oxidative damage in yellow-legged gull embryos during prenatal development.

关键词： Larus michahellis maternal effects morphological traits oxidative status prenatal period vitamin E.

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Measurement of vibration frequencies of ties in masonry arches by means of a robotic total station

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Earthquake Engineering and Engineering Vibration 2022年第2期21卷 489-500页

作者： marco Gatti Dipartimento di Ingegneria University of Ferraravia Saragat 144123 FerraraItaly

Measurement of the vibration frequencies of eight ties set in masonry arches of a church by means of a robotic total station is *** instrument made continuous recordings(up to ten per second)of the three-dimensional positions of a reflector situated at 1/2 or 1/4 of the length of the tie during vertical oscillation induced by an impulsive *** recording slips,vibration amplitudes(and their accuracy),hourly diagram and experimental spectra of vibrations,and the corresponding frequencies were *** results were verified by comparing them with the vibration frequencies and indirectly the tension and fixed support constraint calculated from accelerometric *** study provides interesting information on the accuracies of the reflector′s three-dimensional coordinates,but highlighted certain limits in the application of robotized total stations for measuring vibration frequencies of ties in masonry arches.

关键词： RTS frequency vibrations ties arches

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Arthroscopic vs open ankle arthrodesis:A prospective case series with seven years follow-up

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World Journal of Orthopedics 2021年第12期12卷 1016-1025页

作者： Federico Morelli Giorgio Princi Matteo romano Cantagalli marco Rossini Ludovico Caperna Daniele Mazza Andrea Ferretti Department of Trauma and Orthopaedics Sapienza University of RomeRoma 00189Italy

BACKGROUND The osteoarthritis of the ankle,although less common than other joints,is associated with severe functional *** options are ankle arthroscopic debridement,osteotomies,ankle arthrodesis and ankle *** arthroplasty is increasingly used thanks to the new implants design,but ankle arthrodesis still represents the most used technique and it can be performed arthroscopically or with an open *** To compare mid-term results of arthroscopic vs open ankle arthrodesis of patients affected by end-stage ankle *** This study enrolled 23 patients,which underwent ankle *** patients were divided into 2 groups:group A(open procedure;n=11)and group B(arthroscopic procedure,n=12),the two groups were homogeneous with regard to age and body mass index(P=0.347).The American Orthopaedic Foot and Ankle score(AOFAS),Freiburg Ankle score(FAS)and visual analogue scale for pain intensity were evaluated preoperatively,at six months and at final follow-up of 7.6 years in group A and 7.3 years in group B(P=0.364).RESULTS Patients in the arthroscopic group showed better results at six-month follow-up compared to the open group at the AOFAS(group A,62.2;group B,78.5;P0.05).Hospital stay was shorter in group B than in group A(P=0.001).More complications were reported in the open group than in the arthroscopic group(P=0.459).CONCLUSION The arthroscopic and the open arthrodesis are valid and safe options for the treatment of ankle arthritis on the basis of clinical outcomes at 7 years ***,the arthroscopic treatment shows faster improvement at six-month follow-up in comparison with the open group.

关键词： Ankle Osteoarthritis Arthrodesis Arthroscopy Arthroplasty Surgery

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σ-Phase in Lean Duplex Stainless Steel Sheets

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Acta Metallurgica Sinica(English Letters) 2015年第3期28卷 331-337页

作者： marco Breda Massimo Pellizzari marco Frigo Industrial Engineering Department(DII) University of PadovaVia Marzolo 9Int.435131 PaduaItaly Industrial Engineering Department(DII) University of TrentoVia Mesiano 7738123 TrentoItaly Outokumpu S.p.A. Piazza Piccapietra 916121 GenoaItaly

The precipitation kinetics of secondary phases in two austeno-ferritic lean duplex stainless steels（lean DSS）were examined after aging the materials at 800 ℃.Owing to the instability of ferrite,all DSS are known to be sensitive to solid-state phase transformations in the critical temperature range 600-1,000 ℃ and different secondary phases may form,depending on composition and *** performed thermodynamic simulations revealed the proneness to the precipitation of such phases also have been done in lean DSS,but only information on the equilibrium microstructures were ***,the materials were aged at various times,in order to verify the simulations and determine the precipitation *** occurred structural modifications were observed and quantified by scanning electron microscope and X-ray diffraction measurements,determining phase type,composition and volumetric *** 800 ℃,grade 2101 was found to be only affected by Cr_2N nitrides precipitation,whereas a significant amount of σ-phase was found to form in LDX 2404 for treatment longer than 1 h,almost totally replacing ferrite after 50 *** to now,the intermetallic σ-phase has been observed only in the high alloyed DSS,and the unexpected precipitation in grade 2404 highlighted that the increased content of molybdenum in this steel might be considered as determinant for the formation.

关键词： Lean duplex stainless steels Isothermal heat treatments σ-Phase Chromium nitrides Precipitation kinetics

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Elastic period of vibration calculated experimentally in buildings hosting permanent GPS stations

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Earthquake Engineering and Engineering Vibration 2018年第3期17卷 607-625页

作者： marco Gatti Department of Engineering University of Ferrara

During the earthquake in Emilia（Italy） of 2012,ca.30 permanent GPS stations were in operation within a radius of about 100 km from the epicenter,each equipped with an antenna rigidly fixed to the host building and sampling the GPS signal at a high rate（〉 1 Hz）.From the recording of the GPS measurements,the instantaneous displacements s（t） in the NorthSouth and East-West directions of the phase centers of the single GPS antennas at each permanent station during the most important seismic sequences were calculated in kinematic ***,for each of the two displacements considered as two distinct external forces,the elastic response spectra of the building were determined and from them the two periods of vibration T along two orthogonal directions coinciding with the walls of the building were *** experimentally obtained periods of vibration were compared with those inferable from the technical *** this way,a sufficiently large sample was obtained per building type,geometry（square,rectangular,regular or irregular planimetry）,height（from a minimum of 4 to a maximum of 20 m） and materials（masonry,reinforced concrete,etc.）.From the computational point of view,the study confirmed that GPS is an emerging tool for monitoring dynamic displacements and the experimentally estimated value of T is always lower than the one estimated with the formulae reported in the *** limitations of the study lie in the impossibility to choose a priori the geometry and/or structural type of the building hosting the GPS station.

关键词： permanent GPS stations Emilia-Romagna Italy earthquake period vibrations dynamic structure

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Rare causes of acute non-variceal upper gastrointestinal bleeding: A comprehensive review

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World Journal of Gastroenterology 2023年第27期29卷 4222-4235页

作者： Alberto Martino marco Di Serafino Luigi Orsini Francesco Giurazza Roberto Fiorentino Enrico Crolla Severo Campione Carlo Molino Luigia romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Naples 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Naples 80131Italy Department of Interventional Radiology AORN“Antonio Cardarelli”Naples 80131Italy Department of Oncology AORN“Antonio Cardarelli”Naples 80131Italy Department of Oncological Surgery AORN“Antonio Cardarelli”Naples 80131Italy Department of Pathology AORN“Antonio Cardarelli”Naples 80131Italy

Non-variceal upper gastrointestinal bleeding(NVUGIB)is a common gastroenterological emergency associated with significant morbidity and *** and other involved clinicians are generally assisted by international guidelines in its ***,NVUGIB due to peptic ulcer disease only is mainly addressed by current guidelines,with upper gastrointestinal endoscopy being recommended as the gold standard modality for both diagnosis and ***,the management of rare and extraordinary rare causes of NVUGIB is not covered by current *** they are frequently lifethreatening conditions,all the involved clinicians,that is emergency physicians,diagnostic and interventional radiologists,surgeons,in addition obviously to gastroenterologists,should be aware of and familiar with their ***,they typically require a prompt diagnosis and treatment,engaging a dedicated,patient-tailored,multidisciplinary team *** aim of our review was to extensively summarize the current evidence with regard to the management of rare and extraordinary rare causes of NVUGIB.

关键词： Gastrointestinal bleeding Upper gastrointestinal bleeding Non-variceal upper gastrointestinal bleeding Rare causes Vascular causes Upper endoscopy

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Massive bleeding from gastric submucosal arterial collaterals secondary to splenic artery thrombosis: A case report

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World Journal of Gastroenterology 2022年第37期28卷 5506-5514页

作者： Alberto Martino marco Di Serafino Francesco Paolo Zito Franco Maglione Raffaele Bennato Luigi Orsini Alessandro Iacobelli Raffaella Niola Luigia romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Radiology Sanatrix ClinicNapoli 80127Italy Department of Pathology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Interventional Radiology AORN“Antonio Cardarelli”Napoli 80131Italy

BACKGROUND Gastric submucosal arterial collaterals(GSAC)secondary to splenic artery occlusion is an extraordinary rare and potentially life-threatening cause of acute upper gastrointestinal ***,we report a case of massive bleeding from GSAC successfully treated by means of a multidisciplinary minimally invasive *** SUMMARY A 60-year-old non-cirrhotic gentleman with a history of arterial hypertension was admitted due to *** esophagogastroduodenoscopy revealed pulsating and tortuous varicose shaped submucosal vessels in the gastric fundus along with a small erosion overlying one of the *** order to characterize the fundic lesion,pre-operative emergent computed tomography-angiography was performed showing splenic artery thrombosis(SAT)and tortuous arterial structures arising from the left gastric artery and the left gastroepiploic artery in the gastric *** was successfully treated by means of a minimally invasive step-up approach consisting in endoscopic clipping followed by transcatheter arterial embolization(TAE).CONCLUSION This was a previously unreported case of bleeding GSAC secondary to SAT successfully managed by means of a multidisciplinary minimally invasive approach consisting in endoscopic clipping for the luminal bleeding control followed by elective TAE for the definitive treatment.

关键词： Upper gastrointestinal bleeding Non variceal upper gastrointestinal bleeding Acute upper gastrointestinal bleeding Gastric submucosal arterial collaterals Splenic artery thrombosis Case report

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