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Possible contribution of artificial neural networks and linear discriminant analysis in recognition of patients with suspected atrophic body gastritis

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World Journal of Gastroenterology 2005年第37期11卷 5867-5873页

作者： Edith Lahner Enzo Grossi Marco Intraligi Massimo Buscema Vito D Corleto gianfranco Delle Fave Bruno Annibale Digestive and Liver Disease Unit Ⅱ Medical School Sant' Andrea Hospital University"La Sapienza" Rome Italy Enzo Grossi Bracco Imaging Spa Milan Italy Semeion Research Center Rome Italy

AIM: To investigate whether ANNs and LDA could recognize patients with ABG in a database, containing only clinical and biochemical variables, of a pool of patients with and without ABG, by selecting the most predictive variables and by reducing input data to the ***: Data was collected from 350 consecutive outpatients (263 with ABG, 87 with non-atrophic gastritis and/or celiac disease [controls]). Structured questionnaires with 22 items (anagraphic, anamnestic, clinical, and biochemical data) were filled out for each patient. All patients underwent gastroscopy with biopsies. ANNs and LDA were applied to recognize patients with *** 1: random selection on 37 variables, experiment 2: optimization process on 30 variables, experiment 3:input data reduction on 8 variables, experiment 4: use of only clinical input data on 5 variables, and experiment 5:use of only serological ***: In experiment 1, overall accuracies of ANNs and LDA were 96.6% and 94.6%, respectively, for predicting patients with ABG. In experiment 2, ANNs and LDA reached an overall accuracy of 98.8% and 96.8%,respectively. In experiment 3, overall accuracy of ANNs was 98.4%. In experiment 4, overall accuracies of ANNs and LDA were, respectively, 91.3% and 88.6%. In experiment 5, overall accuracies of ANNs and LDA were,respectively, 97.7% and 94.5%.CONCLUSION: This preliminary study suggests that advanced statistical methods, not only ANNs, but also LDA,may contribute to better address bioptic sampling during gastroscopy in a subset of patients in whom ABG may be suspected on the basis of aspecific gastrointestinal symptoms or non-digestive disorders.

关键词： Atrophic body gastritis Computer-based decision support Gastroscopy Artificial neural networks

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Functional roles of gut bacteria imbalance in cholangiopathies

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Liver Research 2019年第1期3卷 40-45页

作者： Keisaku Sato Fanyin Meng Giammarco Fava Shannon Glaser gianfranco Alpini Division of Research Central Texas Veterans Health Care SystemTempleTXUSA Baylor Scott&White Digestive Disease Research Center Baylor Scott&White Health CareTempleTXUSA Department of Medical Physiology Texas A&M University College of MedicineTempleTXUSA Ospedali Riuniti di Ancona AnconaItaly

Cholangiopathies are caused by bile duct damage or inflammation followed by cholestasis leading to liver *** duct epithelial cells,cholangiocytes,are a primary target for *** reaction is often observed in cholangiopathies and the proliferation of cholangiocytes is associated with ductular reaction and liver *** evidence suggests that patients with chol-angiopathies have different gut bacterial profiles from healthy individuals,indicating the association between gut microbiota and *** acids are produced by hepatocytes and modified by gut *** acids regulate cholangiocyte proliferation but effects vary depending on the type of bile *** studies suggest that therapies targeting gut bacteria,such as antibiotics administration and gut bacteria depletion or therapies using gut bacteria-associated bile acids,such as ursodeoxycholic acid(UDCA)administration,may be useful for treatments of cholangiopathies,although data are contro-versial depending on animal models or *** review summarizes current understandings of functional roles of gut bacterial imbalance and strategies for treatments of cholangiopathies targeting gut bacteria.

关键词： Cholangiopathies Bile acids Gut bacteria Cholangiocytes Cholestasis Inflammation

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Emerging Therapeutic Strategies in The Fight Against Primary Biliary Cholangitis

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 949-957页

作者： Abigail Medford Jonathan Childs Ashleigh Little Sanjukta Chakraborty Leonardo Baiocchi gianfranco Alpini Shannon Glaser Department of Medical Physiology Texas A&M University School of MedicineBryanTXUSA Hepatology Unit University of Tor VergataRomeItaly Division of Gastroenterology and Hepatology Department of MedicineIndiana University School of MedicineIndianapolisINUSA

The liver has a vital role in many metabolic and regulatory processes in the *** biliary cholangitis(PBC),previously known as primary biliary cirrhosis,is a chronic cholestatic autoimmune disease of the intrahepatic bile ducts associated with loss of tolerance to mitochondrial *** this time there is no definitive cure for PBC;however,ursodeoxycholic acid(UDCA)has been shown to reduce injury when administered as the first line of *** therapeutics can be given concurrently or as an alternative to UDCA to manage the symptoms and further curb disease ***,a liver transplant is the only potentially curative option when the patient has developed end-stage liver disease or intractable *** review aims to delineate the pathogenesis of primary biliary cholangitis and shed light on current therapeutic strategies in the treatment of PBC.

关键词： Cholestatic liver disease Therapeutic approaches Biliary epithelia ursodeoxycholic acid

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Heterogeneity of the intrahepatic biliary epithelium

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World Journal of Gastroenterology 2006年第22期12卷 3523-3536页

作者： Shannon Glaser Heather Francis Sharon DeMorrow Gene LeSage Giammarco Fava Marco Marzioni Julie Venter gianfranco Alpini Department of Medicine Division of Research and Education Scott & White Memorial Hospital and The Texas A&M University System Health Science CenterCollege of MedicineTempleTXUnited States Sharon DeMorrow Division of Research and Education Scott & White Memorial Hospital and The Texas A&M University System Health Science CenterCollege of MedicineTempleTXUnited States University of Texas at Houston Medical School Houston TX.United States Department of Gastroenterology Universita Politecnica delle Marche Azienda Ospedaliera "Ospedali Riuniti di Ancona" Ancona Italy Department of Medicine Scott & White Memorial Hospital and The Texas A&M University System Health Science Center College of MedicineTempleTXUnited States Central Texas Veterans Health Care System Department of Medicine Systems Biology and Translational MedicineScott & White Memorial Hospital and The Texas A&M University System Health Science CenterCollege of MedicineTempleTXUnited States

The objectives of this review are to outline the recent findings related to the morphological heterogeneity of the biliary epithelium and the heterogeneous pathophysiological responses of different sized bile ducts to liver gastrointestinal hormones and peptides and liver injury/toxins with changes in apoptotic, proliferative and secretory activities. The knowledge of biliary function is rapidly increasing because of the recognition that biliary epithelial cells （cholangiocytes） are the targets of human cholangiopathies, which are characterized by proliferation/damage of bile ducts within a small range of sizes. The unique anatomy, morphology, innervation and vascularization of the biliary epithelium are consistent with function of cholangiocytes within different regions of the biliary tree. The in vivo models [e.g., bile duct ligation （BDL）, partial hepatectomy, feeding of bile acids,carbon tetrachloride （CCI4） or α-naphthylisothiocyanate（ANIT）] and the in vivo experimental tools [e.g., freshly isolated small and large cholangiocytes or intrahepatic bile duct units （IBDU） and primary cultures of small and large murine cholangiocytes] have allowed us to demonstrate the morphological and functional heterogeneity of the intrahepatic biliary *** models demonstrated the differential secretory activities and the heterogeneous apoptotic and proliferative responses of different sized ducts. Similar to animal models of cholangiocyte proliferation/injury restricted to specific sized ducts, in human liver diseases bile duct damage predominates specific sized bile *** studies related to the functional heterogeneity of the intrahepatic biliary epithelium may disclose new pathophysiological treatments for patients with cholangiopathies.

关键词： cAMP Gastrointestinal hormones Growth factors Mitosis Nerves

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Diagnostic and therapeutic potentials of microRNAs in cholangiopathies

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Liver Research 2017年第1期1卷 34-41页

作者： Lindsey Kennedy Heather Francis Fanyin Meng Shannon Glaser gianfranco Alpini Research Central Texas Veterans Health Care SystemTempleTXUSA Department of Medicine Texas A&M Health Science CenterCollege of MedicineTempleTXUSA Baylor Scott&White Digestive Disease Research Center Baylor Scott&White HealthTempleTXUSA

Cholangiopathies are a group of rare,devastating diseases that arise from damaged cholangiocytes,the cells that line the intra-and extra-hepatic bile ducts of the biliary *** result in significant morbidity and mortality and are a major cause of liver transplantation.A better understanding of the underlying pathogenesis that influences cholangiocyte dysregulation and cholangiopathy progression is necessary,considering the dismal prognosis associated with these *** are a class of small,non-coding RNAs that regulate post-transcriptional mRNA expression of specific *** role of microRNAs has expanded to include the initiation and development of many diseases,including *** microRNA regulation of cholangiopathies may provide diagnostic and therapeutic benefit for these *** this review,the authors primarily focus on studies published within the last five years that help determine the diagnostic and therapeutic potential of microRNAs in cholangiopathies.

关键词： microRNAs Cholangiopathies Diagnosis Therapy

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A Few Questions about Single-Atom Catalysts:When Modeling Helps

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Accounts of Materials Research 2022年第9期3卷 986-995页

作者： Giovanni Di Liberto Sergio Tosoni Luis A.Cipriano gianfranco Pacchioni Dipartimento di Scienza dei Materiali Universitàdi Milano-Bicocca20125 MilanoItaly

CONSPECTUS:Single-atom catalysis(SAC)is a fascinating and rapidly growing field in heterogeneous *** less than 20 years,this has become one of the most widely investigated subjects by the catalytic community for various good reasons:the ability to synthesize active catalysts using a minimum amount of precious metals,the expected higher selectivity of SACs compared to assemblies of nanoparticles of variable sizes,and the fact that SACs represent a bridge between homogeneous and heterogeneous catalysis.

关键词： catalysis catalysis sizes

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Individually administered or co-prescribed thiopurines and mesalamines for inflammatory bowel disease

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World Journal of Gastroenterology 2009年第12期15卷 1420-1426页

作者： Giovanni C Actis Rinaldo Pellicano Mario Rizzetto Muhammad Ayoubi Nicola Leone gianfranco Tappero Paola Pazienza Floriano Rosina Division of Gastro-Hepatology Ospedale GradenigoTorino 10153Italy Division of Gastroenterology Ospedale MolinetteTorino 10153Italy

Data from both basic research and clinical experience continue to suggest that mesalamines and thioputines are effective and efficient for the maintenance of remission of inflammatory bowel diseases. Several decades following the formalization of their indications, attention on these two drugs has been fostered by recent achievements. Demonstration of the ability of mesalamine to activate a colonocyte differentiation factor has shed light on its chemopreventive effects on colorectal cancer; in addition to their anti-proliferative efficacy, thiopurines have been shown to be specific regulators of apoptosis. The two drugs are often coadministered in clinical practice. Recent advancements have shown that mesalamines exert a positive synergism in this context, insofar as they can inhibit sidemethylation of thiopurines and hasten the function of the main immunosuppressive pathways. Considering that up to 40% of patients cannot tolerate thiopurines, such renovated targets have stimulated efforts to improve compliance by research on the toxicity mechanisms. The definition of genetic polymorphisms in the enzymes of thiopurine metabolism, and the uncovering of synergistic drug interactions, such as that with allopurinol, are just two of the results of such efforts. Interaction between basic research and clinical practice has continued to inform indications and refine the prescriptions of mesalamines and thiopurines; these have not been restrained （they have been implemented in some cases） by the advent of the novel biological molecules with anti-cytokine activity.

关键词： Inflammatory bowel disease Mesalamine Thiopurines Azathioprine Remission Drug toxicity

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Estrogens and the pathophysiology of the biliary tree

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World Journal of Gastroenterology 2006年第22期12卷 3537-3545页

作者： Domenico Alvaro Maria Grazia Mancino Paolo Onori Antonio Franchitto gianfranco Alpini Heather Francis Shannon Glaset Eugenio Gaudio Division of Gastroenterology University of Rome "La Sapienza"RomeItaly University of Rome "La Sapienza"Polo PontinoLatinaItaly Division of Gastroenterology University of Rome "La Sapienza"RomeItaly Department of Experimental Medicine Section of Human and Clinical Anatomy State University of L'AquilaL'AquilaItaly Department of Anatomy University of Rome "La Sapienza" RomeItaly Department of Medicine The Texas A&M University System Health Science Center College of Medicine Scott & White HospitalTempleTX 76504United States ResearchCentral Texas Veterans Health Care SystemScott & White HospitalTempleTX 76504United States Systems Biology and Translational MedicineThe Texas A&M University System Health Science Center College of MedicineTX 76504United States Division of R&E Scott & White Hospital TempleTX 76504United States Eugenio Gaudio Department of Anatomy University of Rome "La Sapienza"RomeItaly

The scientific framework concerning estrogen effects on different tissues has expanded enormously during the last decades, when estrogen receptor （ER） subtypes were identified. Estrogens are not only essential for the female reproductive system, but they also control fundamental functions in other tissues including the cardiovascular system, bone, brain and liver. Recently, estrogens have been shown to target the biliary tree, where they modulate the proliferative and secretory activities of cholangiocytes, the epithelial cells lining bile ducts. By acting on both estrogen receptors （ER-α） and （ER-β） subtypes, and by activating either genomic or non-genomic pathways, estrogens play a key role in the complex loop of growth factors and cytokines, which modulates the proliferative response of cholangiocytes to damage. Specifically, estrogens activate intracellular signalling cascades JERK1/2 （extracellular regulated　kinases 1/2, PI3-kinase/AKT （phosphatidylinositol-3＇ kinase/AKT）] typical of growth factors such as insulin like growth factor （IGF1）, nerve growth factor （NGF） and vascular endothelial growth factor （VEGF）, thus potentiating their action. In addition, estrogens stimulate the secretion of different growth factors in proliferating cholangiocytes. This review specifically deals with the recent advances related to the role and mechanisms by which estrogens modulate cholangiocyte functions in normal and pathological conditions.

关键词： Estrogens Cholangiocytes IGF1 Proliferation APDKD PBC Cholangiocarcinoma SERMs

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Calcific degeneration and rupture of the aortic valve and ascending aorta： from cardiac auscultation to multimodality imaging

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Journal of Geriatric Cardiology 2015年第5期12卷 580-583页

作者： Davide Stolfo Pasquale Gianfagna Enrico Fabris Davide Zanuttini gianfranco Sinagra Alessandro Proclemer Gaetano Nucifora Department of Cardiology 'Ospedali Riuniti' and University of Trieste Trieste Italy Cardiothoracic Department University Hospital 'Santa Maria della Misericordia ' Udine Italy

A 76-year-old Caucasian woman was admitted to the emergency room and referred for cardiac evaluation for dyspnea and abrupt onset of cough three weeks ago. She had a history of well-controlled arterial hypertension and was on adequate oral anticoagulant therapy for permanent atrial fibrillation. Previous thoracic injuries, connective tis- sue disorders or recent infections were excluded. No chest pain or syncope was reported. mmHg in both arms, heart rate Blood pressure was 150/50 was 90 beats/min.

关键词： Aortic valve rupture Multislice computed tomography Pseudoaneurysm of the ascending aorta Transesophageal echocardiography

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Adrenal metastasis from endometrial cancer: A case report

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World Journal of Clinical Cases 2019年第14期7卷 1844-1849页

作者： gianfranco Da Dalt Alberto Friziero Andrea Grego Simone Serafini Ambrogio Fassina Stella Blandamura Cosimo Sperti Department of Surgery Oncology and Gastroenterology3rd Surgical ClinicUniversity of Padua Department of Medicine Surgical Pathology and CytopathologyUniversity of Padua

BACKGROUND Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastasizing to the adrenal glands with a review of the English literature on the management of this rare disease. CASE SUMMARY A 53-year-old Caucasian woman with a history of endometrial cancer (grade 2;International Federation of Gynecology and Obstetrics III A) was hospitalized in November 2017 for a left adrenal mass found on a follow-up computed tomography scan 3 years after her gynecological surgery. Laboratory test results were normal. A laparoscopic left adrenalectomy was performed. The postoperative course was uneventful, and no chemotherapy was administered. The pathological report confirmed an adrenal endometrioid metastasis. At 36 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease. A literature review identified only 11 previously-published cases of adrenal metastases from uterine cancer. CONCLUSION Adrenal metastasis from uterine cancer is very rare. Laparoscopic adrenalectomy may be an effective treatment in selected cases of localized adrenal metastasis.

关键词： Adrenal gland Adrenal neoplasms Uterine cancer Laparoscopy Laparoscopic surgery Case report

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