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Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 195-206页

作者： Massimo GIUSTI Davide ORLANDI Giulia MELLE Barbara MASSA enzo SILVESTRI Francesco MINUTO Gianni TURTULICI Endocrine Unit San Martino University Hospital Radiology Unit Evangelico Hospital Cytopathology and Pathology Unit San Martino University Hospital

Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic *** aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological *** study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo ***-histological correlation was available for 38 *** correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was *** addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were *** showed the best specificity and PPV,and FNAB the best *** was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological *** significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other *** sensitivity of the ELX 2/1 index was high,but its specificity was very *** accuracy and PPV of USE were lower than those of the other *** the correlation between Peak index and cumulative US findings reached a value close to *** ultimate aim is to minimise unnecessary *** and FNAB continue to play a central diagnostic *** use of a US score showed high specificity and *** specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological *** and CEUS are innovative techniques that need to be standa

关键词：甲状腺疾病治疗疗效临床

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Long term results of no- alcohol laser epithelial keratomileusis and photorefractive keratectomy for myopia

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International Journal of Ophthalmology(English edition) 2015年第3期8卷 574-579页

作者： Leopoldo Spadea Francesca Verboschi Vittoria De Rosa Mariella Salomone enzo Maria Vingolo Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome

AIM: To evaluate the long term clinical results of mechanical no-alcohol-assisted laser epithelial keratomileusis(LASEK) versus standard photorefractive keratectomy(PRK) for low-moderate ***: Twenty-five eyes treated with LASEK and twenty-five eyes treated with PRK were evaluated with a mean follow-up duration of 60 mo. Mechanical separation of the epithelium was performed with blunt spatula and without application of alcohol. Laser ablation was performed with the MEL-70 excimer laser. All patients were examined daily until epithelial closure; at 1, 3, 6,and 12 mo, and every year subsequently. Main outcome measures were uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA),manifest refraction, haze, efficacy and safety ***: Twenty-one eyes and 22 eyes completed follow-up of 60 mo in LASEK and PRK group respectively. Manifest refraction at 60 mo follow-up was-0.01 and 0.26 in LASEK and PRK group respectively. In the LASEK group mean UDVA and mean CDVA after60 mo were 20/22 and 20/20 respectively(P >0.01). In the PRK group mean UDVA and mean CDVA at 60 mo follow-up were 20/20 and 20/20 after 60mo(P >0.01). The efficacy indexes were 0.87 and 0.95, and the safety indexes were1.25 and 1.4 respectively for LASEK group and PRK ***: Both standard PRK and no-alcohol LASEK offer safe and effective correction of low-moderate myopia in the long term without any statistically significant difference between the two groups.

关键词： alcohol laser epithelial keratomileusis myopia photorefractive keratectomy

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Pre-endoscopic screening for Helicobacter pylori and celiac disease in young anemic women

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World Journal of Gastroenterology 2009年第22期15卷 2748-2753页

作者： Lucy Vannella Debora Gianni Edith Lahner Antonio Amato enzo Grossi Gianfranco Delle Fave Bruno Annibale Department of Digestive and Liver Disease Hospital Sant'AndreaII School of Medicine University Sapienza Center for Thalassemic Disease of Rome Department of Medical Affair Italian Diagnostic Center Department of Digestive and Liver Disease Hospital Sant’AndreaII School of Medicine University Sapienza

AIM:To evaluate the usefulness of pre-endoscopic serological screening for Helicobacter pylori(H pylori) infection and celiac disease in women aged<50 years affected by iron-defi ciency anemia(IDA).METHODS:One hundred and fi fteen women aged<50 years with IDA were tested by human recombinant tissue transglutaminase IgA antibodies(tTG) and anti-H pylori IgG *** and H pylori IgG antibody were assessed using an enzyme-linked immunosorbent assay(ELISA).All women were invited to undergo upper GI *** gastroscopy,biopsies were collected from antrum(n=3),gastric body(n=3) and duodenum(n=4) in all patients,irrespective of test *** assessment of gastritis was performed according to the Sydney system and celiac disease was classifi ed by Marsh's ***:45.2% women were test-positive:41 patients positive for H pylori antibodies,9 patients for tTG and 2 patients for *** gastroscopy compliance rate of test-positive women was significantly increased with respect to those test-negative(65.4% vs 42.8%;Fisher test P=0.0239).The serological results were confi rmed by gastroscopy in 100% of those with positive H pylori antibodies,in 50% of those with positive tTG and in 81.5% of testnegative *** and specif icity were 84.8% and 100%,respectively for H pylori infection and,80% and 92.8% for ***-eight patients had positive H pylori antibodies and in all the patients,an active H pylori infection was *** particular,in 23 out of 28(82%) patients with positive H pylori antibodies,a likely cause of IDA was found because of the active inflammation involving the gastric ***:Anti-H pylori IgG antibody and tTG IgA antibody testing is able to select women with IDA to submit for gastroscopy to identify H pylori pangastritis and/or celiac disease,likely causes of IDA.

关键词：幽门螺杆菌贫血妇女疾病腹腔筛查内镜

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Efficacy and limits of sildenafil citrate in patients with arterial erectile dysfunction： role of peripheral arterial disease and cardiovascular comorbidities

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Asian Journal of Andrology 2008年第6期10卷 847-853页

作者： enzo Vicari Mariano Malaguarnera Sandro La Vignera Fabio Calzavara Carmelo Battiato Aldo E. Calogero Section of Endocrinology Andrology and Internal Medicine and Master in Andrological and Human Reproduction Sciences Department of Biomedical Sciences University of Catania Catania 95123 Italy Department of Senescence Urological and Neurological Sciences University of Catania Catania 95021 Italy

Aim： To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction （ED） was related to their peak systolic velocity （PSV）, peripheral atherosclerosis, cardiovascular risk factors （RF） and/or comorbidities at low cardiovascular risk. Methods： We enrolled 97 patients with 1-2 RF and comorbidities, combined with arterial ED alone （group A, n = 27）, ED plus atherosclerotic carotid artery （group B, n = 23）, ED plus lower limb artery abnormalities （group C, n = 25）, and ED plus carotid and lower limb artery abnormalities （group D, n = 22）. Sildenafil efficacy （100 mg twice a week for 12 weeks） was also examined in patients with ≥ 3 RF, peripheral a（herosclerosis and no cardiovascular comorbidities （group E, n = 20）. Results： Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients （77.8%）, intermediate in groups B and C （65.2% and 56%） and lowest in groups D （45.4%） and E （50%）, and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was nega- tively influenced by：〉 3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidifies was positively related to atherosclerosis localization or extension （25, 35, 38 and 47 in groups A, B, C and D, respectively）. Conclusion： Low sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.

关键词： arterial erectile dysfunction cardiovascular comorbidities peripheral atherosclerosis sildenafil efficacy

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Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection

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Asian Journal of Andrology 2012年第6期14卷 879-883页

作者： Sandro La Vignera Rosita A Condorelli Aldo E Calogero Salvatore Bellanca Mario Salmeri enzo Vicari Section of Endocrinology Andrology and Internal Medicine Department of Medical and Paediatric Sciences University of Catania Policlinico 'G. Rodolico' Catania 95123 ItalY Operative Unit of Marital Infertility Department of Medical Surgical Specialities University of Catania Policlinico 'G. Rodolico' Catania 95123 Italy Section of Microbiology Department of Biomedical Sciences University of Catania Policlinico 'G. Rodolico' Catania 95123 Italy

No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cultures （absent, partial or complete） following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin （a common quinolone antibiotic）, in patients with infections caused by Escherichia coil （a Gram-negative bacterium） according to the Naber＇s classification, which includes the following categories： eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years （range： 20-40 years） with bacterial MAGI and bacterial cultures positive only for E. coil（colony forming units ≥ 106 per ml）. Retrospective analysis was conducted only on patients treated with oral levofloxacin （500 mg） administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis （PV）（30.2% and 36.0%, respectively） or prostato-vesiculo-epididymitis （PVE）（60.2% and 70.0%, respectively） compared with patients with microbiological eradication （PV= 10.2% and PVE=8.2%, respectively） or eradication with superinfection （PV= 18.8% and PVE=21.2%, respectively）. In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI （PV and PVE）, compared with patients with microbiological eradication or eradication with superinfection.

关键词： eradication rate male accessory gland infection microbiological response semen analysis ultrasound changes

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Acquired premature ejaculation and male accessory gland infection： relevance of ultrasound examination

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Asian Journal of Andrology 2016年第5期18卷 769-772页

作者： Sandro La Vignera Rosita A Condorelli enzo Vicari Vincenzo Favilla Giuseppe Morgia Aldo E Calogero Section of Andrology Endocrinology and Internal Medicine Department of Clinical and Experimental Medicine Department of Urology Policlinico 'G. Rodolico'University Hospital University of Catania Catania Italy

We have previously demonstrated a high frequency of premature ejaculation （PE） among patients with male accessory gland infection （MAGI）. The aim of this study was to evaluate the ultrasound （US） features of patients with MAGI and acquired premature ejaculation （APE） associated （MAGI-APEpos）. US evaluation of 50 MAGI-APEpos patients compared to 50 patients with MAGI without PE （MAGI-PEneg） which represent the control group. The diagnosis of APE was made through the evaluation of Intravaginal ejaculation latency time （IELT） and confirmed with the questionnaire PEDT （Premature Ejaculation Diagnostic Tool）. The main outcome measure was represented by the frequency of US criteria suggestive of P （prostatitis）, V （vesiculitis）, and E （epididymitis） in MAGI-APEpos and MAGI-PEneg patients. MAGI-APEpos patients showed a total number of US criteria significantly higher compared to MAGI-PEneg patients. MAGI-APEpos showed a higher frequency of US criteria of V and E （complicated forms of MAGI）. Finally, in MAGI-APEpos group, it was found a positive relationship between the anteroposterior diameter （APD） of the caudal tract of the epididymis and the APD of the seminal vesicles, as well as between both diameters and the PEDT score. MAGI-APEpos patients have a peculiar US characterization compared to MAGI-PEneg patients. According to these results, US evaluation of the epididymal and of the prostato vesicular tract should be considered in the practical clinical approach of patients with MAGI and APE. In particular, it could be a SUDDort for a possible Dathoahysiological interpretation of this clinical problem in these patients.

关键词： male accessory gland infection premature ejaculation ultrasound examination

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Anejaculation in a patient with Charcot-Marie-Tooth

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Asian Journal of Andrology 2018年第5期20卷 529-530页

作者： rossella Cannarella Giovanni Burgio Sandro La Vignera enzo S Vicari Aldo E Calogero Department of Clinical and Experimental Medicine University of Catania Catania95123 Italy

Dear Editor,The occurrence of delayed ejaculation or ane）aculation has been previously suggested in patients with Charcot-Marie-Tooth （CMT） syndrome.1 Despite this, such disorder is rarely investigated and may be underestimated in patients with this disease. We report the case of a 20-year-old men with CMT 1B due to the presence of a punctiform mutation in the exon 2 of the myelin protein zero （MPZ） gene （ 1 q23.3）（Ser78Leu）, complaining for life-long anejaculation. He inherited this mutation from the mother and it has also been detected in his grandmother. No other components of his family were positive at the genetic testing.

关键词： DISEASE

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Transrectal ultrasonography in infertile patients with persistently elevated bacteriospermia

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Asian Journal of Andrology 2008年第5期10卷 731-740页

作者： Sandro La Vignera Aldo E. Calogero Alessandro Arancio Roberto Castiglione Gaetano De Grande enzo Vicari Section of Endocrinology Andrology and Internal Medicine Department of Biomedical Sciences University of Catania 95123 Catania Italy Urology Unit Ospedale Umberto L 96100 Syracuse ltaly

Aim： To identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection （MAGI） who failed to respond to antibacterial treatment. Methods： We selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia （≥ 10^6 colony forming units [CFU]/mL） after three antibiotic courses. Fourteen infertile patients with initial chronic microbial （≥ 10^6 CFU/mL） MAGI who responded to antibacterial treatment （〈 10^3 CFU/mL） served as a control group. All patients and controls underwent transrectal ultrasonography （TRUS） scans and semen analysis. Patients with low seminal plasma volume （〈 1.5 mL） underwent both preejaculatory and post-ejaculatory TRUS examination. Results： TRUS revealed multiple abnormalities indicative of：（i） bilaterally extended prostato-vesiculitis （group A： 52 cases, 77.6%）（nine of these patients also had micro-emphysematous prostate abscess）; and （ii） prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts （group B： 15 cases, 22.4%）. Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls. Conclusion： Although antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria （clinical history, physical and ejaculate signs）. Thus, TRUS may be helpful in the follow-up of these patients.

关键词： persistent bacteriospermia prostato-vesiculitis sub-obstruction of the ejaculatory ducts micro-emphysematous prostate abscess sperm parameters ultrasound features

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Extra-intestinal manifestations of non-celiac gluten sensitivity: an expanding paradigm

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World Journal of Gastroenterology 2018年第14期24卷 1521-1530页

作者： Giuseppe Losurdo Mariabeatrice Principi Andrea Iannone Annacinzia Amoruso enzo Ierardi Alfredo Di Leo Michele Barone Section of Gastroenterology Department of Emergency and Organ Transplantation University "Aldo Moro" of Bari

Non celiac gluten sensitivity(NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease(CD) or wheat allergy. The possibility of systemic manifestations in this condition has been suggested by some reports. In most cases they are characterized by vague symptoms such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness even if more specific complaints have been described. NCGS has an immune-related background. Indeed there is a strong evidence that a selective activation of innate immunity may be the trigger for NCGS inflammatory response. The most commonly autoimmune disorders associated to NCGS are Hashimoto thyroiditis, dermatitis herpetiformis, psoriasis and rheumatologic diseases. The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported; it could be a characteristic feature that could help the diagnosis and be simultaneously managed. A possible neurological involvement has been underlined by NCGS association with gluten ataxia, gluten neuropathy and gluten encephalopathy. NCGS patients may show even psychiatric diseases such as depression, anxiety and psychosis. Finally, a link with functional disorders(irritable bowel syndrome and fibromyalgia) is a topic under discussion. In conclusion, the novelty of this matter has generated an expansion of literature data with the unavoidable consequence that some reports are often based on low levels of evidence. Therefore, only studies performed on large samples with the inclusion of control groups will be able to clearly establish whether the large information from the literature regarding extra-intestinal

关键词： Non celiac gluten sensitivity celiac disease gluten gluten ataxia autoimmunity gluten-related disorders thyroiditis extra-intestinal

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Application of modern timber structure in short and medium span bridges in China

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Journal of Traffic and Transportation Engineering(English Edition) 2014年第1期1卷 72-80页

作者： Meizhen Fu Yongjian Liu Na Li Zhiwei Zhang enzo Siviero School of Highway Chang'an University Department of Architectural Construction IUAV University of Venice

A series of problems about Chinese bridges with short and medium span recent years were analyzed in this paper. The necessity and feasibility of modern timber structure applied in short and medium span bridges in China were also put forward. The results showed that the short and medium span bridges had many problems, such as monotonous structural forms, seri- ous environmental pollution, multiple bridge defects and difficulty in maintenance. With the development of connection and maintenance technology of modern timber structure and its ad- vantages of light self-weight, environmental coordination, high carrying capacity, excellent durability and abundant structural forms, it was necessary and feasible to apply modern timber structure in short and medium span bridges in China. More emphasis on the construction of modern timber structure should be conducted to expand its application scopes and improve the construction proportion of short and medium span timber bridges.

关键词： short and medium span bridges timber structure modern timber bridge application scope

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