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Significance of ipsilateral breast tumor recurrence after breast conserving treatment: role of surgical removal

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Chinese Journal of Cancer Research 2013年第1期25卷 22-31页

作者： romano Demicheli Ilaria Ardoino federico Ambrogi Roberto Agresti Elia Biganzoli Scientific Directorate IRCCS National Cancer Institute Medical Statistics and Biometry University of Milan Breast Surgery IRCCS National Cancer Institute Medical Statistics and Biometry IRCCS National Cancer Institute

Objective： To analyze the pattern over time （dynamics） of further recurrence and death after ipsilateral breast tumor recurrence （IBTR） in breast cancer patients undergoing breast conserving treatment （BCT）. Methods： A total of 338 evaluable patients experiencing IBTR were extracted from a database of 3,293 patients undergoing BCT. The hazard rates for recurrence and mortality throughout 10 years of follow-up after IBTR were assessed and were compared to the analogous estimates associated to the primary treatment. Results： In a time frame with the time origin at the surgical treatment for IBTR, the hazard rate for further recurrence displays a bimodal pattern （peaks at the second and at the sixth year）. Patients receiving mastectomy for IBTR reveal recurrence and mortality dynamics similar to that of node positive （N＋） patients receiving mastectomy as primary surgery, apart from the first two-three years, when IBTR patients do worse. If the patients with time to IBTR longer than 2.5 years are considered, differences disappear. Conclusions： The recurrence and mortality dynamics following IBTR surgical removal is similar to the corresponding dynamics following primary tumor removal. In particular, patients with time to IBTR in excess of 2.5 years behave like N＋ patients following primary tumor removal. Findings may be suitably explained by assuming that the surgical manoeuvre required by IBTR treatment is able to activate a sudden growing phase for tumor foci most of which, as suggested by the systemic model of breast cancer, would have reached the clinical level according to their own dynamics.

关键词： Breast cancer IBTR recurrence dynamics effects of surgery conservative surgery tumor homeostasis

Eradication of Helicobacter pylori infection:Which regimen first?

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World Journal of Gastroenterology 2014年第3期20卷 665-672页

作者： Alessandro federico Antonietta Gerarda Gravina Agnese Miranda Carmela Loguercio Marco romano Department of Clinical and Experimental Medicine Gastroenterology UnitSecond University of Naples

Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although H. pylori is susceptible to several antimicrobials, this infection has proven challenging to cure because of the increasing prevalence of bacterial strains that are resistant to the most commonly used antimicrobials, particularly clarithromycin. An effective (i.e., > 90%) first-line therapy is mandatory for avoiding supplementary treatments and testing, and more importantly for preventing the development of secondary resistance. This study reviews the recent literature on first-line therapies for H. pylori. The eradication rates following standard triple therapy (a proton pump inhibitor plus amoxicillin and clarithromycin) for H. pylori infection are declining worldwide. Several first-line strategies have been proposed to increase the eradication rate, including extending the treatment duration to 14 d, the use of a four-drug regimen (bismuth-containing quadruple, sequential, and concomitant treatments), and the use of novel antibiotics, such as fluoroquinolones. However, the efficacy of these regimens is controversial. A first-line eradication regimen should be based on what works best in a defined geographical area and must take into account the prevalence of antimicrobial resistance in that region.

关键词： Helicobacter pylori Sequential therapy Hybrid therapy Concomitant therapy Clarithromycin Levofloxacin

Fat:A matter of disturbance for the immune system

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World Journal of Gastroenterology 2010年第38期16卷 476-4772页

作者： Alessandro federico Elena D’Aiuto Francesco Borriello Giusi Barra Antonietta Gerarda Gravina Marco romano Raffaele De Palma Section of Gastroenterology Department of Clinical and Experimental MedicineSecond University of Naples Section of Clinical Immunology Department of Clinical and Experimental Medicine Second University of Naples

Obesity is increasingly being recognized as a risk factor for a number of benign and malignant gastrointestinal conditions. However, literature on the underlying pathophysiological mechanisms is sparse and ambiguous. There is compelling evidence that both overnutrition and undernutrition negatively interfere with the immune system. Overnutrition has been found to increase susceptibility to the development of inflammatory diseases, autoimmune diseases and cancer. In the regulation of immune and in? ammatory processes, white adipose tissue plays a critical role, not only as an energy store but also as an important endocrine organ. The obese state is characterised by a low-grade systemic in? ammation, mainly as a result of increased adipocytes as well as fat resident-and recruited-macrophage activity. In the past few years, various products of adipose tissue including adipokines and cytokines have been characterised and a number of pathways linking adipose tissue metabolism with the immune system have been identified. Activation of the innate immune system plays a major role in hepatic steatosis. Non-alcoholic fatty liver disease includes a wide spectrum of diseases, from pure steatosis to non-alcoholic steato-hepatitis in the absence of signif icant alcohol consumption. Although steatosis is considered a non-progressive disease, non-alcoholic steatohepatitis may deteriorate in advanced chronic liver diseases, cirrhosis, and hepatocellular carcinoma. An important parallel between obesityrelated pathology of adipose tissue and liver pertains to the emerging role of macrophages, and growing evidence suggests that Kupffer cells critically contribute to progression of non-alcoholic fatty liver disease. Moreover, a close link between specif ic immune activation and atherosclerosis has been well established, suggesting that fat can directly trigger immune responses. This review discusses the role of fat as "a matter of disturbance for the immune system" with a focus on hepat

关键词： Adipocytokine Adipose tissue Fat Immune system Kupffer cell Natural killer Steatosis

Arthroscopic vs open ankle arthrodesis:A prospective case series with seven years follow-up

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World Journal of Orthopedics 2021年第12期12卷 1016-1025页

作者： federico Morelli Giorgio Princi Matteo romano Cantagalli Marco Rossini Ludovico Caperna Daniele Mazza Andrea Ferretti Department of Trauma and Orthopaedics Sapienza University of RomeRoma 00189Italy

BACKGROUND The osteoarthritis of the ankle,although less common than other joints,is associated with severe functional *** options are ankle arthroscopic debridement,osteotomies,ankle arthrodesis and ankle *** arthroplasty is increasingly used thanks to the new implants design,but ankle arthrodesis still represents the most used technique and it can be performed arthroscopically or with an open *** To compare mid-term results of arthroscopic vs open ankle arthrodesis of patients affected by end-stage ankle *** This study enrolled 23 patients,which underwent ankle *** patients were divided into 2 groups:group A(open procedure;n=11)and group B(arthroscopic procedure,n=12),the two groups were homogeneous with regard to age and body mass index(P=0.347).The American Orthopaedic Foot and Ankle score(AOFAS),Freiburg Ankle score(FAS)and visual analogue scale for pain intensity were evaluated preoperatively,at six months and at final follow-up of 7.6 years in group A and 7.3 years in group B(P=0.364).RESULTS Patients in the arthroscopic group showed better results at six-month follow-up compared to the open group at the AOFAS(group A,62.2;group B,78.5;P0.05).Hospital stay was shorter in group B than in group A(P=0.001).More complications were reported in the open group than in the arthroscopic group(P=0.459).CONCLUSION The arthroscopic and the open arthrodesis are valid and safe options for the treatment of ankle arthritis on the basis of clinical outcomes at 7 years ***,the arthroscopic treatment shows faster improvement at six-month follow-up in comparison with the open group.

关键词： Ankle Osteoarthritis Arthrodesis Arthroscopy Arthroplasty Surgery

Liver failure in an obese middle-aged woman after biliointestinal bypass

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World Journal of Clinical Cases 2013年第1期1卷 52-55页

作者： Dolores Sgambato Gaetano Cotticelli Ilario de Sio Annalisa Funaro Anna Del Prete Chiara de Sio Lorenzo romano Alessandro federico Antonietta Gravina Agnese Miranda Carmelina Loguercio Marco romano Department of Clinical and Experimental Medicine "Magrassi-Lanzara" Gastroenterology Unit Second University of Naples 80131 Naples Italy

Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty liver disease. Among the therapeutic options for morbid obesity, bariatric surgery plays an important role when conventional therapies fail. The effects of bariatric surgery on liver function and morphology are controversial in the literature. Liver failure has been reported after jejunoileal bypass(JIB), biliopancreatic diversion and gastric bypass. Biliointestinal bypass(BIB) is considered an effective procedure among recently introduced bariatric surgery techniques. It is a clinically safe, purely malabsorptive operation in which the blind intestinal loop of the JIB is anastomosed to the gallbladder, allowing a portion of bile to transit into excluded intestinal tract. BIB is the only procedure, to our knowledge, to have no liver side effects reported in the literature. We report the case of a young obese woman who developed liver failure 8 mo after BIB. She had a rapid weight loss(70 kg) with a reduction in body mass index of 41% from January to September 2012. Because of a severe hepatic decompensation, she was referred to a transplantation centre. We strongly believe that the most important pathogenetic mechanism involved in the development of liver injury is the rapid weight loss that produced a signif icant fatty liver inf iltration.

关键词： Bariatric surgery Biliointestinal bypass Liver failure Non-alcoholic fatty liver disease Obesity Rapid weight loss

Hericium erinaceus,a medicinal fungus with a centuries-old history:Evidence in gastrointestinal diseases

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World Journal of Gastroenterology 2023年第20期29卷 3048-3065页

作者： Antonietta Gerarda Gravina Raffaele Pellegrino Salvatore Auletta Giovanna Palladino Giovanni Brandimarte Rossella D'Onofrio Giusi Arboretto Giuseppe Imperio Andrea Ventura Marina Cipullo Marco romano Alessandro federico Department of Precision Medicine University of Campania“Luigi Vanvitelli”Naples 80138Italy Division of Internal Medicine and Gastroenterology Cristo Re HospitalRome 00167Italy

Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for *** studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel *** addition,some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal *** review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.

关键词： Hericium erinaceus Fungus Gastritis Inflammatory bowel diseases Gastric cancer Colorectal cancer

Helicobacter pylori gamma-glutamyl transpeptidase and its pathogenic role

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World Journal of Gastroenterology 2014年第3期20卷 630-638页

作者： Vittorio Ricci Maria Giannouli Marco romano Raffaele Zarrilli Department of Molecular Medicine Human Physiology SectionUniversity of Pavia Medical School Department of Public Health Hygiene SectionUniversity of Naples "Federico Ⅱ" Department of Clinical and Experimental Medicine Chair of GastroenterologySecond University of Naples CEINGE Biotecnologie Avanzate

Helicobacter pylori(***)gamma-glutamyl transpeptidase(GGT)is a bacterial virulence factor that converts glutamine into glutamate and ammonia,and converts glutathione into glutamate and *** GGT causes glutamine and glutathione consumption in the host cells,ammonia production and reactive oxygen species *** products induce cell-cycle arrest,apoptosis,and necrosis in gastric epithelial *** GGT may also inhibit apoptosis and induce gastric epithelial cell proliferation through the induction of cyclooxygenase-2,epidermal growth factor-related peptides,inducible nitric oxide synthase and *** GGT induces immune tolerance through the inhibition of T cell-mediated immunity and dendritic cell *** effect of GGT on *** colonization and gastric persistence are also discussed.

关键词： Helicobacter pylori Gamma-glutamyl transpeptidase Bacterial virulence factor Gastric epithelial cell damage T cell-mediated immunity

Bone alterations in inflammatory bowel diseases

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World Journal of Clinical Cases 2019年第15期7卷 1908-1925页

作者： Dolores Sgambato Francesca Gimigliano Cristiana De Musis Antimo Moretti Giuseppe Toro Emanuele Ferrante Agnese Miranda Domenico De Mauro Lorenzo romano Giovanni Iolascon Marco romano Departments of Precision Medicine and Polyspecialistic Internal Medicine University of Campania "Luigi Vanvitelli" and University HospitalNaples 80131Italy Department of Physical and Mental Health University of Campania“Luigi Vanvitelli”Naples 80131Italy Department of Medical and Surgical Specialties and Dentistry University of Campania“Luigi Vanvitelli”Naples 80131Italy Surgical Digestive Endoscopy Department of Clinical Medicine and SurgeryFederico Ⅱ UniversityNaples 80131Italy

Inflammatory bowel diseases(IBDs)are characterized by a multifactorial partially unknown etiology that involves genetic,immunological and environmental *** to 50%of IBD patients experience at least one extraintestinal manifestation;among them is the involvement of bone density which is referred to as metabolic bone disease(MBD),including osteopenia and *** alterations in IBDs population appear to have a multifactorial etiology:Decreased physical activity,inflammation-related bone resorption,multiple intestinal resections,dietary malabsorption of minerals and vitamin D deficiency,genetic factors,gut-bone immune signaling interaction,steroid treatment,microbiota and pathogenic micro-organisms interaction,and dietary malabsorption of minerals,that,all together or individually,may contribute to the alteration of bone mineral *** review aims to summarize the prevalence and pathophysiology of metabolic bone alterations in IBD subjects outlining the main risk factors of bone *** also want to underline the role of the screening and prophylaxis of bone alterations in Crohn’s disease and ulcerative colitis patients and the importance of treating appropriately MBD.

关键词： Inflammatory bowel diseases Bone alterations Bone mineral density Osteoporosis Osteopenia Ulcerative colitis Crohn’s disease

Scaffold proteins of cancer signaling networks: The paradigm of FK506 binding protein 51 (FKBP51) supporting tumor intrinsic properties and immune escape

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Oncology Research 2023年第4期31卷 423-436页

作者： LAURA MARRONE MASSIMO D’AGOSTINO CAROLINA GIORDANO VALERIA DI GIACOMO SIMONA URZINI CHIARA MALASOMMA MARIA PAOLA GAMMELLA MARTINA TUFANO SIMONA romano MARIA FIAMMETTA romano Department of Molecular Medicine and Medical Biotechnology University of Naples Federico IINaples80131Italy Dipartimento di Diagnostica per Immagini e Neuroradiologia Fondazione Policlinico Universitario“A.Gemelli”IRCCSUniversitàCattolica S.CuoreRomeItaly

Scaffold proteins are crucial regulators of signaling networks,and their abnormal expression may favor the development of *** the scaffold proteins,immunophilin covers a unique role as‘protein-philin’(Greek‘philin’=friend)that interacts with proteins to guide their proper *** growing list of human syndromes associated with the immunophilin defect underscores the biological relevance of these proteins that are largely opportunistically exploited by cancer cells to support and enable the tumor’s intrinsic *** the members of the immunophilin family,the FKBP5 gene was the only one identified to have a splicing *** cells impose unique demands on the splicing machinery,thus acquiring a particular susceptibility to splicing *** review article aims to overview the current knowledge of the FKBP5 gene functions in human cancer,illustrating how cancer cells exploit the scaffolding function of canonical FKBP51 to foster signaling networks that support their intrinsic tumor properties and the spliced FKBP51s to gain the capacity to evade the immune system.

关键词： Immunophilin Alternative splicing Signal transduction