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Evolution of incidental branch-duct intraductal papillary mucinous neoplasms of the pancreas: A study with magnetic resonance imaging cholangiopancreatography

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World Journal of Gastroenterology 2016年第43期22卷 9562-9570页

作者： Rossano Girometti riccardo pravisani Sergio Giuseppe Intini Miriam Isola Lorenzo Cereser Andrea Risaliti Chiara Zuiani Institute of Diagnostic Radiology Department of Medical and Biological Sciences University of Udine University Hospital "S. Maria della Misericordia" Clinical Surgery Department of Medical and Biological Sciences University of Udine University Hospital "S. Maria della Misericordia" Department of Medical and Biological Sciences University of Udine

AIM To investigate the type and timing of evolution of incidentally found branch-duct intraductal papillary mucinous neoplasms(bd-IPMN) of the pancreas addressed to magnetic resonance imaging cholangiopancreatography(MRCP) *** We retrospectively evaluated 72 patients who underwent, over the period 2006-2016, a total of 318 MRCPs(mean 4.4) to follow-up incidental, presumed bdIPMN without signs of malignancy, found or confirmedat a baseline MRCP examination. Median follow-up time was 48.5 mo(range 13-95 mo). MRCPs were acquired on 1.5T and/or 3.0T systems using 2D and/or 3D technique. Image analysis assessed the rates of occurrence over the follow-up of the following outcomes:(1) imaging evolution, defined as any change in cysts number and/or size and/or appearance; and(2) alert findings, defined as worrisome features and/or high risk stigmata(e.g., thick septa, parietal thickening, mural nodules and involvement of the main pancreatic duct). Time to outcomes was described with the Kaplan-Meir approach. Cox regression model was used to investigate clinical or initial MRCP findings predicting cysts *** We found a total of 343 cysts(per-patient mean 5.1) with average size of 8.5 mm(range 5-25 mm). Imaging evolution was observed in 32/72 patients(44.4%; 95%CI: 32-9-56.6), involving 47/343 cysts(13.7%). There was a main trend towards small( 0.01).CONCLUSION Changes in MRCP appearance of incidental bd-IPNM were frequent over the follow-up(44.4%), with relatively rare(8.3%) occurrence of non-malignant alert findings that prompted further diagnostic steps. Cha

关键词：胰包囊分支管 intraductal 乳突的 mucinous 瘤磁性的回声 cholangiopancreatography 后续

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Is there any correlation between Iiver graft regeneration and recipient's pretransplant skeletal muscle mass?-a study in extended Ieft Iobe graft Iiving-donor Iiver transplantation

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 183-194页

作者： riccardo pravisani Akihiko Soyama Shinichiro Ono Umberto Baccarani Miriam Isola Mitsuhisa Takatsuki Masaaki Hidaka Tomohiko Adachi Takanobu Hara Takashi Hamada Florian Pecquenard Andrea Risaliti Susumu Eguchi Department of Surgery Nagasaki University Graduate School of Biomedical SciencesNagasakiJapan Liver-Kidney Transplant Unit Department of MedicineUniversity of UdineUdineItaly Division of Medical Statistic Department of MedicineUniversity of UdineUdineItaly

Background:The end-stage liver disease causes a metabolic dysfunction whose most prominent clinical feature is the loss of skeletal muscle mass(SMM).In living-donor liver transplantation(LDLT),liver graft regeneration(GR)represents a crucial process to normalize the portal hypertension and to meet the metabolic demand of the *** data are available on the correlation between pre-LDLT low SMM and ***:Retrospective study on a cohort of 106 LDLT patients receiving an extended left liver lobe *** skeletal muscle index(SMI)at L3 level was used for muscle mass measurement,and the recommended cut-off values of the Japanese Society of Hepatology guidelines were used as criteria for defining low *** was evaluated as rate of volume increase at 1 month post-LT[graft regeneration rate(GRR)].Results:The median GRR at 1 month post-LT was 91%(IQR,65-128%)and a significant correlation with graft volume-to-recipient standard liver volume ratio(GV/SLV)(rho-0.467,P<0.001),graft-to-recipient weight ratio(GRWR)(rho-0.414,P<0.001),donor age(rho-0.306,P=0.001),1 month post-LT cholinesterase serum levels(rho 0.397,P=0.002)and pre-LT low muscularity[absent *** GRR 97.5%(73.1-130%)vs.83.5%(45.2-110.9%),P=0.041]was *** in male recipients,but not in women,it was shown a direct correlation with pre-LT SMI(rho 0.352,P=0.020)and inverse correlation with 1 month post-LT SMI variation(rho-0.301,P=0.049).A low GRR was identified as an independent prognostic factor for recipient overall survival(HR 6.045,P<0.001).Conclusions:Additionally to the hemodynamic factors of portal circulation and the quality of the graft,the metabolic status of the recipients has a significant role in the GR process.A pre-LT low SMM is associated with impaired GRR and this negative impact is more evident in male recipients.

关键词： Liver regeneration living-donor liver transplantation(LDLT) skeletal muscle mass index sarcopenia malnutrition

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