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Robot-assisted trans-gastric drainage and debridement of walled-off pancreatic necrosis using the EndoWrist stapler for the da Vinci Xi:A case report

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World Journal of Clinical Cases 2019年第12期7卷 1461-1466页

作者： Luca Morelli Niccolò Furbetta Desirée Gianardi matteo Palmeri Gregorio Di Franco matteo bianchini Gianni Stefanini Simone Guadagni Giulio Di Candio General Surgery Unit Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa Pisa 56124 Italy EndoCAS (Center for Computer Assisted Surgery) University of Pisa Pisa 56124 Italy

BACKGROUND Walled-off pancreatic necrosis (WOPN) is a late complication of acute pancreatitis. The management of a WOPN depends on its location and on patient's symptoms. Trans-gastric drainage and debridement of WOPN represents an important surgical treatment option for selected patients. The da Vinci surgical System has been developed to allow an easy, minimally invasive and fast surgery, also in challenging abdominal procedures. We present here a case of a WOPN treated with a robotic trans-gastric drainage using the da Vinci Xi. CASE SUMMARY A 63-year-old man with an episode of acute necrotizing pancreatitis was referred to our center. Six wk after the acute episode the patient developed a walled massive fluid collection, with an extensive pancreatic necrosis, causing obstruction of the gastrointestinal tract. The patient underwent a robotic transgastric drainage and debridement of the WOPN performed with the da Vinci Xi platform. Firstly, an anterior ideal gastrotomy was carried out, guided by intraoperative ultrasound (US)-scan using the TilePro? function. Then, through the gastrotomy, the best location for drainage on the posterior gastric wall was again US-guided identified. The anastomosis between the posterior gastric wall and the walled-off necrosis wall was carried out with the new EndoWrist stapler with vascular cartridge. Debridement and washing of the cavity through the anastomosis were performed. Finally, the anterior gastrotomy was closed and the cholecystectomy was performed. The postoperative course was uneventful and a post-operative computed tomography-scan showed the collapse of the fluid collection. CONCLUSION In selected cases of WOPN the da Vinci Surgical System can be safely used as a valid surgical treatment option.

关键词： Case report da Vinci Xi EndoWrist stapler Walled-off pancreatic necrosis TilePro Minimally-invasive surgery

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Tissue microarray-chip featuring computerized immunophenotypical characterization more accurately subtypes ampullary adenocarcinoma than routine histology

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World Journal of Gastroenterology 2020年第43期26卷 6822-6836页

作者： matteo Palmeri Niccola Funel Gregorio Di Franco Niccolo Furbetta Desiree Gianardi Simone Guadagni matteo bianchini Luca E Pollina Claudio Ricci Marco Del Chiaro Giulio Di Candio Luca Morelli General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Division of Surgical Pathology University-Hospital of PisaPisa 56124Italy Department of Surgical MedicalMolecular Pathology and Critical AreaUniversity of PisaPisa 56124Italy Department of Surgery University of ColoradoDenverCO 80045United States

BACKGROUND Ampullary adenocarcinomas(AACs)are heterogeneous tumors currently classified into three important sub-classes(SC):Intestinal(INT),Pancreato-Biliary(PB)and Mixed-Type(MT).The different subgroups have similar clinical presentation and are treated by pancreatoduodenectomy with curative intent.However,they respond differently to chemotherapy and have different prognostic outcomes.The SC are often difficult to identify with conventional histology alone.The clinical outcome of all three remains unclear,particularly for MT.AIM To identify two main subtypes of AACs,using an immunohistochemical(IHC)score based on CDX2,CK7 and CK20.METHODS Tissue samples from 21 patients who had undergone resection of AAC were classified by HE histology and IHC expression of CDX2,CK7 and CK 20.An IHC score was obtained for each marker by counting the number of positive cells(0=no stained cells;150%)and their intensity(1=weak;2=moderate and 3=strong).A global score(GS)was then obtained by summation of the IHC scores of each marker.The MT tumors were grouped either with the INT or PB group based on the predominant immuno-molecular phenotype,obtaining only two AACs subtypes.The overall survival in INT and PB patients was obtained by Kaplan-Meier methods.RESULTS Histological parameters defined the AACs subtypes as follows:15%INT,45%PB and 40%MT.Using IHC expression and the GS,75%and 25%of MT samples were assigned to either the INT or the PB group.The mean value of the GS was 9.5(range 4-16).All INT samples had a GS above the average,distinct from the PB samples which had a GS score significantly below the average(P=0.0011).The INT samples were identified by high expression of CDX2 and CK20,whereas PB samples exhibited high expression of CK7 and no expression of CK20(P=0.0008).The INT group had a statistically significant higher overall survival than in the PB group(85.7 mo vs 20.3 mo,HR:8.39;95%CI:1.38 to 18.90;P=0.0152).CONCLUSION The combination of histopathological and molecular criteria enables the classification

关键词： Ampullary adenocarcinoma Histo-molecular phenotype Prognostic CK7 CK20 CDX2

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Use of zebrafish embryos as avatar of patients with pancreatic cancer:A new xenotransplantation model towards personalized medicine

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World Journal of Gastroenterology 2020年第21期26卷 2792-2809页

作者： Gregorio Di Franco Alice Usai Niccola Funel matteo Palmeri Ida Elena Rosamaria Montesanti matteo bianchini Desirée Gianardi NiccolòFurbetta Simone Guadagni Enrico Vasile Alfredo Falcone Luca Emanuele Pollina Vittoria Raffa Luca Morelli General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Department of Biology University of PisaPisa 56127Italy Division of Surgical Pathology Department of Laboratory of MedicineHospital-University of PisaPisa 56124Italy Division of Medical Oncology Pisa University HospitalPisa 56124Italy Department of Translational Research and New Technologies in Medicine and Surgery University of PisaPisa 56124Italy EndoCAS(Center for Computer Assisted Surgery) University of PisaPisa 56124Italy

BACKGROUND The response to chemotherapy treatment of patients with pancreatic ductal adenocarcinoma(PDAC)is difficult to predict and the identification of patients who most likely will benefit from aggressive chemotherapy approaches is crucial.The concept of personalized medicine has emerged in the last years with the objective to tailor the medical treatment to the individual characteristics of each patient,and particularly to the tumor biology of each patient.The need for invivo xenotransplantation models for cancer patients has increased exponentially,and for this reason zebrafish avatars have gained popularity.Preliminary studies were conducted also with PDAC tissue.AIM To develop a simple,not expensive,diffusible zebrafish embryo model as avatar for patients affected by PDAC.METHODS Tumor tissue was taken from the surgical specimen by the histopathologist.After its fragmentation into small pieces,they are stained with CM-Dil.Small pieces of stained tissue were transplanted into the yolk of wt AB zebrafish embryos with a glass capillary needle.Embryos were incubated at 35°C in E3 medium supplemented with 1%Pen/Strep in the presence or absence of drugs for the following days in respect of the treatment plan(Gemcitabine;Gemcitabine and Oxaliplatin;Gemcitabine and nab-Paclitaxel;5-Fluorouracil and Folinic acid and Oxaliplatin and Irinotecan).The response of zebrafish xenografts to the chemotherapy options has been analyzed by monitoring the fluorescent stained area at 2 h post injection(hpi),1 d and 2 d post injection(dpi).In each time point,the mean size of the stained area was measured by ImageJ and it was normalized with respect to the 1 dpi time point mean relative tumor area(RTA).We evaluated the effect of the chemotherapy exposition comparing the mean RTA of each treated subgroup and the control group and evaluating the percentage reduction of the mean RTA by comparing each treated subgroup with the control group.RESULTS Between July 2018 and October 2019,a total of 15 patients with pancreatic cancer were

关键词： Pancreatic ductal adenocarcinoma Zebrafish embryos Personalized medicine Xenotransplantation Chemotherapy efficacy Avatar of oncological patients

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The interplay between (electro)chemical and (chemo)mechanical effects in the cycling performance of thiophosphate-based solid-state batteries

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Materials Futures 2022年第1期1卷 122-134页

作者： Jun Hao Teo Florian Strauss Felix Walther Yuan Ma Seyedhosein Payandeh Torsten Scherer matteo bianchini Jürgen Janek Torsten Brezesinski Battery and Electrochemistry Laboratory Institute of NanotechnologyKarlsruhe Institute of Technology(KIT)Hermann-von-Helmholtz-Platz 176344 Eggenstein-LeopoldshafenGermany Institute of Physical Chemistry&Center for Materials Research Justus-Liebig-University GiessenHeinrich-Buff-Ring 1735392 GiessenGermany KNMF Laboratory for Micro-and Nanostructuring Institute of NanotechnologyKarlsruhe Institute of Technology(KIT)Hermann-von-Helmholtz-Platz 176344 Eggenstein-LeopoldshafenGermany BASF SE Carl-Bosch-Str.3867056 LudwigshafenGermany

Solid-state batteries(SSBs)are a promising next step in electrochemical energy storage but are plagued by a number of problems.In this study,we demonstrate the recurring issue of mechanical degradation because of volume changes in layered Ni-rich oxide cathode materials in thiophosphate-based SSBs.Specifically,we explore superionic solid electrolytes(SEs)of different crystallinity,namely glassy 1.5Li_(2)S-0.5P_(2)S_(5)-LiI and argyrodite Li_(6)PS_(5)Cl,with emphasis on how they affect the cyclability of slurry-cast cathodes with NCM622(60%Ni)or NCM851005(85%Ni).The application of a combination of ex situ and in situ analytical techniques helped to reveal the benefits of using a SE with a low Young’s modulus.Through a synergistic interplay of(electro)chemical and(chemo)mechanical effects,the glassy SE employed in this work was able to achieve robust and stable interfaces,enabling intimate contact with the cathode material while at the same time mitigating volume changes.Our results emphasize the importance of considering chemical,electrochemical,and mechanical properties to realize long-term cycling performance in high-loading SSBs.

关键词： solid-state battery slurry casting lithium thiophosphate electrolyte Ni-rich NCM cathode degradation

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Detailing the ultrastructure’s increase of prion protein in pancreatic adenocarcinoma

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World Journal of Gastroenterology 2021年第42期27卷 7324-7339页

作者： matteo bianchini Maria Anita Giambelluca Maria Concetta Scavuzzo Gregorio Di Franco Simone Guadagni matteo Palmeri NiccolòFurbetta Desirée Gianardi Niccola Funel Claudio Ricci Raffaele Gaeta Luca Emanuele Pollina Alfredo Falcone Caterina Vivaldi Giulio Di Candio Francesca Biagioni Carla Letizia Busceti Luca Morelli Francesco Fornai General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Human Anatomy Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Division of Surgical Pathology Department of SurgicalMedicalMolecular Pathology and Critical AreaUniversity of PisaPisa 56124Italy Division of Medical Oncology Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy IRCCS Neuromed Istituto Neurologico MediterraneoPozzilli 86077Italy EndoCAS(Center for Computer Assisted Surgery) University of PisaPisa 56124Italy

BACKGROUND Recent evidences have shown a relationship between prion protein(PrPc)expression and pancreatic ductal adenocarcinoma(PDAC).Indeed,PrPc could be one of the markers explaining the aggressiveness of this tumor.However,studies investigating the specific compartmentalization of increased PrPc expression within PDAC cells are lacking,as well as a correlation between ultrastructural evidence,ultrastructural morphometry of PrPc protein and clinical data.These data,as well as the quantitative stoichiometry of this protein detected by immuno-gold,provide a significant advancement in understanding the biology of disease and the outcome of surgical resection.AIM To analyze quantitative stoichiometry and compartmentalization of PrPc in PDAC cells and to correlate its presence with prognostic data METHODS Between June 2018 and December 2020,samples from pancreatic tissues of 45 patients treated with pancreatic resection for a preoperative suspicion of PDAC at our Institution were collected.When the frozen section excluded a PDAC diagnosis,or the nodules were too small for adequate sampling,patients were ruled out from the present study.Western blotting was used to detect,quantify and compare the expression of PrPc in PDAC and control tissues,such as those of non-affected neighboring pancreatic tissue of the same patient.To quantify the increase of PrPc and to detect the subcellular compartmentalization of PrPc within PDAC cells,immuno-gold stoichiometry within specific cell compartments was analyzed with electron microscopy.Finally,an analysis of quantitative PrPc expression according to prognostic data,such as cancer stage,recurrence of the disease at 12 mo after surgery and recurrence during adjuvant chemotherapy was made.RESULTS The amount of PrPc within specimen from 38 out of 45 patients was determined by semi-quantitative analysis by using Western blotting,which indicates that PrPc increases almost three-fold in tumor pancreatic tissue compared with healthy pancreatic regions[242.41±28.36 optical density(OD)v

关键词： Pancreatic ductal adenocarcinoma Prion protein Western blotting Electron microscopy Cellular compartmentalization Neuroinvasion

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The interplay of drug therapeutics and immune responses to SARS-CoV-2

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Cellular & Molecular Immunology 2024年第2期21卷 197-200页

作者： Valeria Fumagalli matteo Iannacone Division of Immunology Transplantationand Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilanItaly Vita-Salute San Raffaele University MilanItaly Experimental Imaging Centre IRCCS San Raffaele Scientific InstituteMilanItaly

The SARS-CoV-2 pandemic has necessitated rapid therapeutic and preventative responses.While vaccines form the frontline of defense,antiviral treatments such as nirmatrelvir have emerged as vital adjunctive measures,particularly for those unable or unwilling to be vaccinated.This review delves into the potential influence of nirmatrelvir on enduring immunity.In parallel,the potential of drug repurposing is explored,with bisphosphonates being examined for their possible effects against COVID-19 due to their immunomodulatory properties.The importance of rigorous clinical trials and careful interpretation of preliminary data is emphasized.

关键词： SARS-CoV-2 Nirmatrelvir Bisphosphonates Adaptive immunity Drug repurposing

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Pediatric stricturing Crohn's disease

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World Journal of Gastroenterology 2024年第12期30卷 1651-1654页

作者： Alessandro Boscarelli matteo Bramuzzo Department of Pediatric Surgery and Urology Institute for Maternal and Child Health-IRCCS“Burlo Garofolo”Trieste 34137Italy Department of Gastrointestinal Endoscopy and Nutrition Institute for Maternal and Child Health-IRCCS"Burlo Garofolo"Trieste 34137Italy

Crohn’s disease(CD)is a chronic inflammatory disease of the digestive tract.The incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 world-wide.Notably,approximately 25%of children with CD develop stricturing CD(SCD)that requires intervention.Symptomatic stricturing diseases refractory to pharmacological management frequently require non-pharmacological interventions.Non-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured seg-ment.However,strictures tend to recur postoperatively regardless of treatment modality.The lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.

关键词： Stricturing Crohn’s disease Pediatrics Insights Future perspectives

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Recent Advances in the Synthesis and Polymerization of New CO_(2)-Based Cyclic

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Chinese Journal of Chemistry 2024年第4期42卷 430-443页

作者： matteo Lanzi Arjan W.Kleij Institute of Chemical Research of Catalonia(ICIQ) The Barcelona Institute of Science and Technology(BIST)Av.Països Catalans 1643007 TarragonaSpain Catalan Institute of Research and Advanced Studies(ICREA) Pg.Lluís Companys 2308010 BarcelonaSpain

Carbon dioxide can be converted into functional heterocycles known as cyclic carbonates,whose recent reactivity has been expanded towards the formation of tailor-made engineering polymers.This minireview gives an overview of the most topical developments in this area with a special focus on the synthetic methods employed to prepare these CO_(2)based synthons.In addition,their application potential in the area of polymer science using a variety of polymerization techniques is discussed that have in common the ring-opening of the carbonate monomers.Future perspectives are provided that provide impetus for the scientific communities aligning research to the use of sustainable processes for polymers from recyclable carbon sources such as CO_(2).

关键词： Carbon dioxide Cyclic carbonates Functional macromolecules Heterocycles Polycarbonates Recycling Ring opening polymerization

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Janus-faced Mitofusin 2 (MFN2): mitochondria-endoplasmic reticulum shaping and tethering functions unveiled

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Signal Transduction and Targeted Therapy 2024年第2期9卷 341-342页

作者： Camilla Aurora Franchino Elisa Motori matteo Bergami Institute for Biochemistry University of Cologne50674 CologneGermany Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases(CECAD) Faculty of Medicine and University Hospital CologneUniversity of Cologne50931 CologneGermany Center for Molecular Medicine 50931 CologneGermany

In a recently published study in Science,Naòn et al.report two uncharacterized splice variants of Mitofusin 2(MFN2)that specifically shape and tether the endoplasmic reticulum(ER)to mitochondria.1 This work sheds new light on the pleiotropic effects previously ascribed to MFN2 loss-of-function mutations,and has important implications for associated metabolic and neurological diseases.

关键词： MFN2 reticulum

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Prevention of hepatitis B reactivation in patients with hematologic malignancies treated with novel systemic therapies:Who and Why?

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World Journal of Gastroenterology 2024年第5期30卷 509-511页

作者： matteo Tonnini Clara Solera Horna Luca Ielasi Department of Medical and Surgical Sciences University of BolognaBologna 40138Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Infectious Disease Unit Azienda USL-IRCCS di Reggio EmiliaReggio Emilia 42123Italy Department of Internal Medicine Ospedale degli Infermi di FaenzaFaenza 48018Italy

The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.

关键词： Hepatitis B reactivation Hepatitis B virus Antiviral prophylaxis Hematologic malignancies Chimeric antigens receptor-T cell therapy Immune checkpoint inhibitors

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