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Resective surgery for liver tumor: a multivariate analysis of causes and risk factors linked to postoperative complications

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Hepatobiliary & Pancreatic Diseases International 2006年第4期5卷 526-533页

作者： Enrico Benzoni Dario Lorenzin Umberto Baccarani Gian Luigi Adani alessandro Favero alessandro cojutti Fabrizio Bresadola alessandro Uzzau Department of Surgery University of Udine School of Medicine Udine Italy

BACKGROUND: In spite of accurate selection of patients eligible for resection, and although advances in surgical techniques and perioperative management have greatly contributed to reducing the rate of perioperative deaths, stress must be placed on reducing the postoperative complication rates reported to be still as high as 50%. This study was designed to analyze the causes and foreseeable risk factors linked to postoperative morbidity on the grounds of data derived from a single-center surgical population. METHODS: From September 1989 to March 2005, 287 consecutive patients, affected either with HCC or liver metastasis, had liver resection at our department. Among the HCC series we recorded 98 patients (73.2%) in Child- Pugh class A, 32 (23.8%) in class B and 4 in class C (3%). In 104 colorectal metastases, 71% were due to colon cancer, 25% rectal, 3% sigmoid, and 1% anorectal. In 49 non-colorectal metastases, 22.4% were derived from breast cancer, 63.2% gastrointestinal tumors (excluding colon) and 14.4% other cancers. We performed 80 wedge resections, 77 bisegmentectomies and/or left lobectomies, 74 segmentectomies, 22 major hepatectomies, 20 left hepatectomies, and 14 trisegmentectomies. RESULTS: The in-hospital mortality rate in this series was 4.5%, and the morbidity rate was 47.7%, because of pleural effusion (30%), hepatic abscess (25%), hepatic insufficiency (19%), ascites (10%), hemoperitoneum (10%), or biliary fistula (6%). The variables associated with the technical aspects of the surgical procedure thatwere responsible for the complications were: a Pringle maneuver length more than 20 minutes (P=0.001); the type of liver resection procedure, including major hepatectomy (P=0.02), left hepatectomy (P=0.04), trisegmentectomy (P=0.04), bisegmentectomy and/or left lobectomy (P=0,04); and a blood transfusion of more than 600 ml (P=0.04). CONCLUSION: The evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of

关键词： carcinoma, hepatocellular liver metastases liver resection postoperative complications biliary leakage pleural effusion impaired liver function

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Conformational dynamics as an intrinsic determinant of prion protein misfolding and neurotoxicity

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Neural Regeneration Research 2024年第10期19卷 2095-2096页

作者： alessandro Cembran Pedro Fernandez-Funez Department of Chemistry and Biochemistry University of Minnesota DuluthDuluthMNUSA Department of Biomedical Sciences University of Minnesota Medical SchoolDuluth CampusDuluthMNUSA

The prion protein(PrP) is the key molecular and pathological mediator of prion diseases,a heterogeneous group of brain disorders with fatal *** diseases are rare but deserve special attention because of their unique f... 详细信息

关键词： folding intrinsic dynamics

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Beyond functional MRI signals:molecular and cellular modifiers of the functional connectome and cognition

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Neural Regeneration Research 2024年第5期19卷 937-938页

作者： Lorenzo Pini alessandro Salvalaggio Maurizio Corbetta Padova Neuroscience Center University of PadovaItaly Veneto Institute of Molecular Medicine VIMMPadovaItaly Department of Neuroscience University of PadovaItaly

Our brain is constantly *** at rest,the brain carries out essential functions such as maintenance of resting potentials,subthreshold synaptic activity,and spiking activity related to information *** resting activity can be assessed with several in vivo tools,such as resting-state functional magnetic resonance *** technique measures subtle changes in blood flow,volume,and oxygenation that occur over *** vascular in nature,resting-state functional magnetic resonance imaging is considered a reliable proxy of neural activity and several studies have shown that the brain is functionally divided into interacting neural networks called the“functional connectome”.

关键词： functional neural measures

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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 *** incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 ***,approximately 25%of children with CD develop stricturing CD(SCD)that requires *** stricturing diseases refractory to pharmacological management frequently require non-pharmacological ***-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured ***,strictures tend to recur postoperatively regardless of treatment *** 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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Non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini alessandro Fogliati Mauro alessandro Scotti Cristina Ciulli Francesca Carissimi Antonio Rovere Luca Gianotti Fabrizio Romano Unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(NAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of NAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for NAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with NAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-IN”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:Ninety-seven patients who underwent NAR were included;76%were SegSubTe-IN and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-IN ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-IN ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(P<0.001).Conclusions:The SegSubTe classification is a useful tool to stratify and standardize NAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of NAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound Liver surgery Computed tomography Surgical procedure

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Optimal orbit transfer of single-tether E-sail with inertially fixed spin axis

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Astrodynamics 2024年第2期8卷 285-295页

作者： alessandro A.Quarta Marco Bassetto Giovanni Mengali Department of Civil and Industrial Engineering University of PisaPisa I-56122Italy

This study analyzes the optimal transfer trajectory of a spacecraft propelled by a spinstabilized electric solar wind sail(E-sail)with a single conducting tether and a spin axis with a fixed direction in an inertial(heliocentric)reference *** approach proposed in this study is useful for rapidly analyzing the optimal transfer trajectories of the current generation of small spacecraft designed to obtain in-situ evidence of the E-sail propulsion *** this context,starting with the recently proposed thrust model for a single-tether E-sail,this study discusses the optimal control law and performance in a typical two-dimensional interplanetary transfer by considering the(binary)state of the onboard electron emitter as the single control *** resulting spacecraft heliocentric trajectory is a succession of Keplerian arcs alternated with propelled arcs,that is,the phases in which the electron emitter is switched *** particular,numerical simulations demonstrated that a single-tether E-sail with an inertially fixed spin axis can perform a classical mission scenario as a circle-to-circle two-dimensional transfer by suitably varying a single control parameter.

关键词： electric solar wind sail(E-sail) single conducting tether fixed inertial spin axis trajectory optimization circle-to-circle coplanar transfer

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A comprehensive review on the processing-property relationships of laser strengthened magnesium

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Journal of Magnesium and Alloys 2024年第1期12卷 1-34页

作者： alessandro M.Ralls Aaksheta Agnel Pradeep L.Menezes Department of Mechanical Engineering University of Nevada RenoRenoNV 89557United States

Among the existing series of softer metals,magnesium(Mg)has attracted much attention due to its impressive strength-to-weight ***,due to its ease of deformability,Mg tends to suffer from rapid degradation in a wide variety of abrasive and electrochemical *** method of improving its surface properties is through surface modification *** the existing techniques,laser shock peening(LSP)has been one of the most widely utilized processes due to its surface-hardening-like *** this understanding,a comprehensive review has yet to exist that encapsulates the strengthening mechanism of LSP for Mg and its influence in degradation *** review aims to encapsulate the existing research around the LSP field for ***,an understanding of the surface-strengthening effects in relation to its mechanical,tribological,corrosion,and tribo-corrosion characteristics is ***,the feasibility of LSP for Mg materials in critical industries is also *** this work,a novel understanding of LSP for Mg can be understood,which can provide a future direction for research in this field.

关键词： Laser shock peening Magnesium Surface deformation Tribology Microstructure

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Spark Plasma Sintering of Mg-based Alloys:Microstructure,Mechanical Properties,Corrosion Behavior,and Tribological Performance

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Journal of Magnesium and Alloys 2024年第2期12卷 405-442页

作者： alessandro M.Ralls Mohammadreza Daroonparvar Pradeep L.Menezes Department of Mechanical Engineering University of Nevada RenoRenoNV89557United States

Within the past ten years,spark plasma sintering(SPS)has become an increasingly popular process for Mg *** the SPS process,interparticle diffusion of compressed particles is rapidly achieved due to the concept of Joule *** to traditional and additive manufacturing(AM)techniques,SPS gives unique control of the structural and microstructural features of Mg *** doing so,their mechanical,tribological,and corrosion properties can be *** great advancements in this field have been made,these pieces of knowledge are scattered and have not been contextualized into a single *** motivation of this work is to address this scientific gap and to provide a groundwork for understanding the basics of SPS manufacturing for *** do so,the existing body of SPS Mg literature was first surveyed,with a focus on their structural formation and degradation *** was found that successful Mg SPS fabrication highly depended on the processing temperature,particle size,and particle *** addition of metal and ceramic composites also affected their microstructural features due to the Zener pinning *** degradative environments,their performance depends on their structural features and whether they have secondary phased *** industrial applications,SPS'd Mg was found to have great potential in biomedical,hydrogen storage,battery,automotive,and recycling *** prospects to advance the field include using Mg as a doping agent for crystallite size refinement and using bulk metallic Mg-based glass powders for amorphous SPS *** these findings,the interactions of multi-composites on the processing-structure-property relationships of SPS Mg is not well *** total,this work will provide a useful direction in the SPS field and serve as a milestone for future Mg-based SPS manufacturing.

关键词： Spark plasma sintering Magnesium alloys Nanocrystalline Tribology Mechanical properties Corrosion

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Local recurrence rate as quality indicator in surgery for pancreatic cancer?

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 548-550页

作者： Carlo Alberto Pacilio alessandro Cucchetti Giorgio Ercolani General and Oncologic Surgery Unit Morgagni-Pierantoni HospitalAUSL RomagnaVia Carlo Forlanini 3447121ForlìItaly Department of Medical and Surgical Sciences Alma Mater StudiorumUniversity of BolognaVia Massarenti 940138BolognaItaly

To the Editor: As we all know, even with the current advancements regarding novel chemotherapy regimens, patients affected by pancreatic cancer(PC) have an extremely dismal prognosis(5-year survival rate 12% for all stages in the National Cancer Institute SEER database). Among the patients undergoing surgical treatment, the prognosis is mostly affected by recurrence. PC after surgery has mainly four patterns of recurrence, isolated or variously associated with each other: local, lymph nodal, peritoneal or distant(liver, lung, other sites).

关键词： surgery prognosis cancer

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A Methodology for Vulnerability Assessment of Cultural Heritage in Extreme Climate Changes

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International Journal of Disaster Risk Science 2024年第03期15卷 404-420页

作者： Riccardo Cacciotti alessandro Sardella Milo? Drdácky Alessandra Bonazza Institute of Theoretical and Applied Mechanics Czech Academy of Sciences Institute of Atmospheric Sciences and Climate National Research Council of Italy Department of Environmental and Prevention Sciences University of Ferrara Istituto Superiore per la Protezione e la Ricerca Ambientale

Vulnerability evaluation plays a key role in risk assessment and reduction and is essential for defining strategies for climate change adaptation and mitigation. In dealing with the safeguarding of cultural heritage at risk, we are still far from adopting and applying an agreed methodology for vulnerability assessment. With the aim to support practitioners, heritage managers,and policy and decision makers to undertake actions that address the protection of cultural heritage at risk, the methodology set up in the framework of the Interreg Central Europe STRENCH is illustrated and discussed here. Based on three major requirements(susceptibility, exposure, and resilience) and a continuous consultation with local stakeholders, the proposed methodology is applicable for evaluating the vulnerability of built heritage and cultural landscape exposed to hydrometeorological hazards, such as heavy rains, floods, and droughts. The results obtained through its validation on 15 case studies from seven Central European regions are shown to underline the strengths and limitations of the methodological *** consultation with local stakeholders was fundamental for the definition of the criteria/subcriteria and related values for the assessment of the requirements. Application to further sites in other contexts would surely contribute to strengthening the reliability of the methodological approach.

关键词： Built and natural heritage Exposure Heritage vulnerability Resilience Risk management Susceptibility

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