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Protective benefit of minimally invasive liver surgery for hepatocellular carcinoma prior to transplant

Hepatoma Research 2022年第1期8卷 179-187页

作者： Simone Khouzam Duilio Pagano marco Barbara vito di marco Giada Pietrosi marco Maringhini marco Canzonieri Sergio Calamia Salvatore Gruttadauria Sidney Kimmel Medical College Thomas Jefferson UniversityPhiladelphiaPA 19107USA Department for the Treatment and Study of Abdominal diseases and Abdominal Transplantation IRCCS-ISMETT(Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per I Trapianti e Terapie ad Alta Specializzazione)UPMC(University of Pittsburgh Medical Center)via E.Tricomi 5Palermo 90127Italy Sezione di Gastroenterologia e Epatologia Dipartimento Biomedico di Medicina Interna e SpecialisticaUniversity of PalermoPalermo 90128Italy Medicina Interna Universitàdi Palermo/ISMETTVia del Vespro 129Palermo 90127Italy Department of Surgery and Medical and Surgical Specialties University of CataniaCatania 95124Italy

Aim:The purpose of this study is to assess the benefit of laparoscopic liver resection(LLR)for hepatocellular carcinoma(HCC)given recurrence and future need for liver transplantation(LT).Methods:Data on liver resections were gathered from the Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione(IRCCS-ISMETT)from 2003-2021.A retrospective analysis of 1408 consecutive adult patients who had a liver resection was performed with categorization based on the underlying disease process.A sub-analysis studied the 291 patients who had an LLR with an intention to transplant approach after LLR.Results:From 2012 to 2020,ISMETT’s mean annual LLR rate was 45%.Data suggests that a laparoscopic approach to iterative surgical treatment for HCC has demonstrated protective benefits.Compared to open surgery or LT,LLR is protective against the risk of de-listing,post-transplant patient death,tumor recurrence,adhesions,and bleeding in a cirrhotic patient.Kaplan Meier’s analysis showed no difference between post-LT survival curves for those with prior open abdominal surgery or LLR(P=0.658).Conclusion:Laparoscopic surgery has important protective advantages over laparotomy surgery for the surgical treatment of HCC,particularly since treatment is not always curative.LLR can be considered a bridge therapy for transplantation,ensuring less crowding of waiting lists,a desirable condition in areas of donor storage.

关键词： Laparoscopic liver resection hepatocellular carcinoma minimally invasive liver surgery

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Hyperferritinemia is a risk factor for steatosis in chronic liver disease

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World Journal of Gastroenterology 2009年第17期15卷 2132-2138页

作者： Anna Licata Maria Elena Nebbia Giuseppe Cabibbo Giovanna Lo Iacono Francesco Barbaria Virna Brucato Nicola Alessi Salvatore Porrovecchio vito di marco Antonio Craxì Calogero Cammà Gastroenterology and Hepatology Unit Department of Internal Medicine University of Palermo 90127 Palermo Italy

AIM: To investigate the relationship between ferritin and steatosis in patients with chronically abnormal liver function tests (LFTs) and high ferritin level. METHODS: One hundred and twenty-four consecutive patients with hyperferritinemia (male > 300 ng/mL, female > 200 ng/mL) were evaluated; clinical, biochemical and serological data, iron status parameters, HFE gene mutations and homeostasis model assessment score were obtained. Steatosis was graded by ultrasound as absent or present. Histology was available in 53 patients only. RESULTS: Mean level of ferritin was 881 ± 77 ng/mL in men and 549 ± 82 ng/mL in women. The diagnosis was chronic hepatitis C in 53 (42.7%), non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in 57 (45.9%), and cryptogenic liver damage in 14 (11.3%). None was diagnosed as hereditary hemochromatosis (HH). Hepatic siderosis on liver biopsy was present in 17 of 54 (32%) patients; grade 1 in eight and grade 2 in nine. Overall, 92 patients (74.2%) had steatosis. By logistic regression, ferritin and γ-glutamyltransferase were independent predictors of steatosis. Ferritin levels were signifi cantly related to low platelet count, steatosis and hepatitis C virus infection. CONCLUSION: In a non-obese cohort of non-alcoholic patients with chronically abnormal LFTs without HH, high serum ferritin level is a risk factor for steatosis.

关键词：非酒精性脂肪性肝炎慢性肝病危险因素 Logistic回归遗传性血色素沉着症慢性丙型肝炎独立预测因子谷氨酰转移酶

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different doses of consensus interferon plus ribavirin in patients with hepatitis C virus genotype 1 relapsed after interferon monotherapy:A randomized controlled trial

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World Journal of Gastroenterology 2006年第42期12卷 6861-6864页

作者： Giuseppe Alaimo vito di marco Donatella Ferraro Rosa di Stefano Salvatore Porrovecchio Francesca D’Angelo Vincenza Calvaruso Antonio Craxì Piero Luigi Almasio Cattedra di Gastroenterologia Dipartimento Biomedico di Medicina Interna e Specialistica University of Palermo Italy Cattedra di Virologia Di-partimento di Igiene e Microbiologia University of Palermo Italy

AIM: To assess the efficacy of different schedules of consensus interferon (CIFN) plus ribavirin in retreating chronic hepatitis C patients who relapsed after recombinant interferon (rIFN) monotherapy. METHODS: Forty-five patients (34 males and 11 females) with chronic hepatitis due to hepatitis C virus (HCV) genotype 1 who relapsed after a previous course of rIFN monotherapy were randomized to receive 9 μg CIFN three times per week for 52 wk (group A, n = 22) or 18 μg CIFN three times per week for 52 wk (group B, n = 23) in combination with ribavirin 800 to 1200 mg daily for 52 wk (according to body weight). Virological response was evaluated at week 24 (EVR), at the end of treatment (ETR) and at 76 wk (SVR). RESULTS: By intention-to-treat analysis, subjects in group A had an EVR in 35% of cases, an ETR in 35% and a SVR in 27.3% of cases. Subjects in group B had an EVR in 32% of cases, an ETR in 35% and a SVR in 26.1% of cases. Treatment was stopped because of adverse effects (mostly intolerance) in 15 patients (6 in group A and 9 in group B). IFN dose reduction was needed in 2 patients (1 in group A and 1 in group B). Ribavirin dose was reduced in 2 patients in group A and 1 in group B respectively. Among the 15 subjects who received at least 80% of the intended schedule, the rate of SVR was 80% (6 in group A and 6 in group B). CONCLUSION: CIFN in combination with ribavirin when given to HCV genotype 1 relapsers after rIFN monotherapy obtains an unsatisfactory rate of sustainedviral clearance independently of dosage of the drug. This may be due to its scarce tolerability.

关键词：唑核苷病毒唑丙型病毒肝炎治疗

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untreatable hepatocellular 癌的自然历史: 回顾的队研究

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World Journal of Hepatology 2012年第9期4卷 256-261页

作者： Giuseppe Cabibbo Marcello Maida Chiara Genco Pietro Parisi marco Peralta Michela Antonucci Giuseppe Brancatelli Calogero Cammà Antonio Craxì vito di marco Section of Gastroenterology Department of Internal Medicine and Biomedical SpecialistUniversity of PalermoPalermo 90127Italy Department of Biopathology and Biomedical Methodologies University of PalermoPalermo 90127Italy Department of Oncology Division of General Surgery and OncologyUniversity of PalermoPalermo 90127Italy Department of Radiology DIBIMEFUniversity of PalermoPalermo 90127Italy

AIM:To investigate the clinical course of untreatable hepatocellular carcinoma(HCC) identified at any stage and to identify factors associated with mortality.METHODS:From January 1999 to December 2010,320 out of 825 consecutive patients with a diagnosis of HCC and not appropriate for curative or palliative treatments were followed and managed with supportive therapy.Cirrhosis was diagnosed by histological or clinical features and liver function was evaluated according to Child-Pugh score.The diagnosis of HCC was performed by Ultra-Sound guided biopsy or by multiphasic contrast-enhanced computed tomography or gadolinium-enhanced magnetic resonance imaging.Data were collected for each patient including all clinical,laboratory and imaging variables necessary for the outcome prediction staging systems considered.HCC staging was performed according Barcelona Clinic Liver Cancer(BCLC) and Cancer of the Liver Italian Program scores.Follow-up time was defined as the number of months from the diagnosis of HCC to death.Prognostic baseline variables were analyzed by multivariate Cox analysis to identify the independent predictors of survival.RESULTS:Seventy-five per cent of patients had hepatitis C.Ascites was present in 169 patients(53%),while hepatic encephalopathy was present in 49 patients(15%).The Child-Pugh score was class A in 105 patients(33%),class B in 142 patients(44%),and class C in 73 patients(23%).One hundred patients(31%) had macroscopic vascular invasion and/or extrahepatic spread of the tumor.A single lesion > 10 cm was observed in 34 patients(11%),while multinodular HCC was present in 189 patients(59%).Thirty nine patients(12%) were BCLC early(A) stage,55(17%) were BCLC intermediate(B) stage,124(39%) were BCLC advanced(C) stage,and 102(32%) were endstage BCLC(D).At the time of this analysis(July 2011),28(9%) patients were still alive.Six(2%) patients who were lost during follow-up were censored at the last visit.The overall median survival was 6.8 mo,and the 1-year survival was 32%.The 1-year survival a

关键词： Hepatocellular carcinoma Liver Cancer Survival Prognosis Natural history

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Lower limb suspension induces threshold-specific alterations of motor units properties that are reversed by active recovery

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Journal of Sport and Health Science 2024年第2期13卷 264-276页

作者： Giacomo Valli Fabio Sarto Andrea Casolo Alessandro Del Vecchio Martino V.Franchi marco V.Narici Giuseppe De vito Department of Biomedical Sciences University of PadovaPadova 35131Italy Department Artificial Intelligence in Biomedical Engineering Friedrich-Alexander UniversityErlangen-Nurnberg 91052Germany

Purpose:This study aimed to non-invasively test the hypothesis that(a) short-term lower limb unloading would induce changes in the neural control of force production(based on motor units(MUs) properties) in the vastus lateralis muscle and(b) possible changes are reversed by active recovery(AR).Methods:Ten young males underwent 10 days of unilateral lower limb suspension(ULLS) followed by 21 days of AR.During ULLS,participants walked exclusively on crutches with the dominant leg suspended in a slightly flexed position(15°-20°) and with the contralateral foot raised by an elevated shoe.The AR was based on resistance exercise(leg press and leg extension) and executed at 70% of each participant’s 1repetition maximum,3 times/week.Maximal voluntary isometric contraction(MVC) of knee extensors and MUs properties of the vastus lateralis muscle were measured at baseline,after ULLS,and after AR.MUs were identified using high-density electromyography during trapezoidal isometric contractions at 10%,25%,and 50% of the current MVC,and individual MUs were tracked across the 3 data collection points.Results:We identified 1428 unique MUs,and 270 of them(18.9%) were accurately tracked.After ULLS,MVC decreased by 29.77%,MUs absolute recruitment/derecruitment thresholds were reduced at all contraction intensities(with changes between the 2 variables strongly correlated),while discharge rate was reduced at 10% and 25% but not at 50% MVC.Impaired MVC and MUs properties fully recovered to baseline levels after AR.Similar changes were observed in the pool of total as well as tracked MUs.Conclusion:Our novel results demonstrate,non-invasively,that 10 days of ULLS affected neural control predominantly by altering the discharge rate of lower-threshold but not of higher-threshold MUs,suggesting a preferential impact of disuse on motoneurons with a lower depolarization threshold.However,after 21 days of AR,the impaired MUs properties were fully restored to baseline levels,highlighting the plasticity of the components involved in neural cont

关键词： disuse High-density EMG Muscle disuse Neural impairment Neuromuscular degeneration

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Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy Department of Urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy Urology Unit "G.Tatarlla"HospitalCerignola 71042Italy Urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania Department of Oncological Urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy Department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy Urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male LUTS.The aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still lacking.Most of them are still under investigation and,to date,only a few options have been given as a recommendation for use.They cannot be considered as standard of care and are not suitable for all patients.Advantages and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

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Fat management in upper blepharoplasty:Addition or subtraction blepharoplasties,how and when

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World Journal of Clinical Cases 2024年第16期12卷 2796-2802页

作者： Giovanni Miotti Jacopo di Filippo Martina Grando Carlo Salati Pier Camillo Parodi Leopoldo Spadea Caterina Gagliano Mutali Musa marco Zeppieri Department of Plastic Surgery University Hospital of UdineUdine 33100Italy Department of Internal Medicine Azienda Sanitaria Friuli OccidentaleSan Vito al Tagliamento 33078Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Eye Clinic Policlinico Umberto I"Sapienza"University of RomeRome 00142Italy Department of Medicine and Surgery University of Enna"Kore"Enna 94100Italy Eye Clinic Catania University San Marco HospitalCatania 95121Italy Department of Optometry University of BeninBenin 3000283Nigeria Department of Ophthalmology Centre for Sight AfricaNkporOnitsha 434112Niger

BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are f

关键词： Blepharoplasty Fat pads Eye lid surgery Cosmetic aesthetic surgery Rejuvenation Plastic surgery

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Unlocking the versatile potential:Adipose-derived mesenchymal stem cells in ocular surface reconstruction and oculoplastics

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World Journal of Stem Cells 2024年第2期16卷 89-101页

作者： Pier Luigi Surico Anna Scarabosio Giovanni Miotti Martina Grando Carlo Salati Pier Camillo Parodi Leopoldo Spadea marco Zeppieri Schepens Eye Research Institute of Mass Eye and Ear Harvard Medical SchoolBostonMA 02114United States Department of Ophthalmology Campus Bio-Medico UniversityRome 00128Italy Department of Plastic Surgery University Hospital of UdineUdine 33100Italy Department of Internal Medicine Azienda Sanitaria Friuli OccidentaleSan Vito al Tagliamento 33078Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Eye Clinic Policlinico Umberto I“Sapienza”University of RomeRome 00142Italy

This review comprehensively explores the versatile potential of mesenchymal stem cells(MSCs)with a specific focus on adipose-derived MSCs.Ophthalmic and oculoplastic surgery,encompassing diverse procedures for ocular and periocular enhancement,demands advanced solutions for tissue restoration,functional and aesthetic refinement,and aging.Investigating immunomodulatory,regenerative,and healing capacities of MSCs,this review underscores the potential use of adipose-derived MSCs as a cost-effective alternative from bench to bedside,addressing common unmet needs in the field of reconstructive and regenerative surgery.

关键词： Stem cells Adipose stem cell Ocular therapy Oculoplastics Regenerative

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Hepatitis B virus reactivation in patients treated with monoclonal antibodies

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World Journal of Virology 2024年第1期13卷 33-37页

作者： Silvia De Pauli Martina Grando Giovanni Miotti marco Zeppieri Department of Internal Medicine Azienda Sanitaria Friuli OccidentaleSan Vito al TagliamentoPordenone 33170Italy Department of Plastic Surgery University Hospital of UdineUdine 33100Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Hepatitis B virus(HBV)reactivation poses a significant clinical challenge,espe-cially in patients undergoing immunosuppressive therapies,including mono-clonal antibody treatments.This manuscript briefly explores the complex rela-tionship between monoclonal antibody therapy and HBV reactivation,drawing upon current literature and clinical case studies.It delves into the mechanisms underlying this phenomenon,highlighting the importance of risk assessment,monitoring,and prophylactic measures for patients at risk.The manuscript aims to enhance the understanding of HBV reactivation in the context of monoclonal antibody therapy,ultimately facilitating informed clinical decision-making and improved patient care.This paper will also briefly review the definition of HBV activation,assess the risks of reactivation,especially in patients treated with monoclonal antibodies,and consider management for patients with regard to screening,prophylaxis,and treatment.A better understanding of patients at risk can help clinicians provide optimum management to ensure successful patient outcomes and prevent morbidity.

关键词： Hepatitis B virus Reactivation Acute infection Chronic infection Monoclonal antibodies

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Fat or fillers:The dilemma in eyelid surgery

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World Journal of Clinical Cases 2024年第17期12卷 2951-2965页

作者： Giovanni Miotti Luca De marco Davide Quaglia Martina Grando Carlo Salati Leopoldo Spadea Caterina Gagliano Mutali Musa Pier Luigi Surico Pier Camillo Parodi marco Zeppieri Department of Plastic Surgery University Hospital of UdineUdine 33100Italy Department of Internal Medicine Azienda Sanitaria Friuli OccidentaleSan Vito al Tagliamento 33078Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Eye Clinic Policlinico Umberto I“Sapienza”University of RomeRome 00142Italy Department of Medicine and Surgery University of Enna“Kore”Enna 94100Italy Eye Clinic Catania University San marco Hospital Viale Carlo Azeglio CiampiCatania 95121Italy Department of Optometry University of BeninBenin 300283Nigeria Department of Ophthalmology Africa Eye Laser CentreKm 7Benin 300105Nigeria Schepens Eye Research Institute of Mass Eye and Ear Harvard Medical SchoolBostonMA 02114United States

The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,the change in the concept of a young look,considered then“full”,led to the increasing use of surgical(fat grafting)or medical(hyaluronic acid)filling techniques.Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments,with a focus on achieving a youthful and refreshed appearance.Among the various techniques available,the choice between using fat grafting or fillers presented a clinical dilemma.In particular,what surgery considered of fundamental importance was a long-lasting result over time.On the other hand,aesthetic medicine considered it fundamental not to have to resort to invasive treatments.But what was the reality?Was there one path better than the other,and above all,was there a better path for patients?The minireview aims to explore the physiopathology,diagnosis,treatment options,prognosis,and future studies regarding this dilemma.We analyzed the literature produced in the last 20 years comparing the two techniques.Current literature reveals advancements in biomaterials,stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation.The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma.Understanding physiopathology,accurately diagnosing eyelid aging,exploring treatment options,assessing prognosis,and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.

关键词： Stem cells Adipose stem cell Ocular therapy Oculoplastics Regenerative

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