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World Journal of Gastroenterology 2008年第35期14卷 5471-5473页

作者： Paolo Aseni Stefano Di Sandro Plamen Mihaylov luca lamperti Luciano Gregorio De Carlis Liver Transplantation Center Niguarda Ca' Granda HospitalMilan 20162Italy

Piodermal gangrenosum (PG) is an uncommon ulcerative cutaneous dermatosis associated with a variety of systemic diseases, including inflammatory bowel disease (IBD), arthritis, leukaemia, hepatitis, and primary billiary cirrhosis. Other cutaneous ulceration resembling PG had been described in literature. There has been neither laboratory finding nor histological feature diagnostic of PG, and diagnosis of PG is mainly made based on the exclusion criteria. We present here a patient, with ulcerative colitis (UC) who was referred to the emergency section with a large and rapidly evolving cutaneous ulceration. Laboratory and microbiological investigation associated with histological findings of the ulcer specimen allowed us to exclude autoimmune and systemic diseases as well as immuno-proliferative disorders. An atypical presentation of PG with UC was diagnosed. Pulse boluses of i.v. methyl-prednisolone were started, and after tapering steroids, complete resolution of the skin lesion was achieved in 3 wk. The unusual rapid healing of the skin ulceration with steroid mono-therapy and the atypical cutaneous presentation in this patient as well as the risk of misdiagnosis of PG in the clinical practice were discussed.

关键词： Ulcerative colitis Pioderma gangrenosum Steroids Cutaneous lesion Immunosuppression

Repair of a mal-repaired biliary injury:A case report

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World Journal of Gastroenterology 2009年第18期15卷 2283-2286页

作者： Awad Aldumour Paolo Aseni Mohmmad Alkofahi luca lamperti Elias Aldumour Paolo Girotti Luciano Gregorio De Carlis Department of Hepatobiliary Surgery and Liver Transplantation Unit Niguarda Hospital20162 MilanItaly

Iatrogenic bile-duct injury post-laparoscopic cholecystectomy remains a major serious complication with unpredictable long-term results. We present a patient who underwent laparoscopic cholecystectomy for gallstones, in which the biliary injury was recognized intraoperatively. The surgical procedure was converted to an open one. The first surgeon repaired the injury over a T-tube without recognizing the anatomy and type of the biliary lesion, which led to an unusual biliary mal-repair. Immediately postoperatively, the abdominal drain brought a large amount of bile. A T-tube cholangiogram was performed. Despite the contrast medium leaking through the abdominal drain, the mal-repair was recognized intraoperatively. The surgical procedure was converted to an open one. The first surgeon repaired the injury over a T-tube without recognizing the anatomy and type of the biliary lesion, which led to an unusual biliary mal-repair. Immediately postoperatively, the abdominal drain brought a large amount of bile. A T-tube cholangiogram was performed. Despite the contrast medium leaking through the abdominal drain, the mal-repair was unrecognized. The patient was referred to our hospital for biliary leak. Ultrasound and cholangiography was repeated, which showed an unanatomical repair （right to left hepatic duct anastomosis over the T-tube）,with evidence of contrast medium coming out through the abdominal drain. Eventually the patient was subjected to a definitive surgical treatment. The biliary continuity was re-established by a Roux-en-Y hepaticojejunostomy, over transanastomotic external biliary stents. The patient is now doing well 4 years after the second surgical procedure. In reviewing the literature, we found a similar type of injury but we did not find a similar surgical real-repair. We propose an algorithm for the treatment of early and late biliary injuries.

关键词： Biliary tract injury Surgical complication Biliary surgery Laparoscopic cholecystectomy

Systematic review of ablative therapy for the treatment of renal allograft neoplasms

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World Journal of Clinical Cases 2019年第17期7卷 2487-2504页

作者： Evaldo Favi Nicholas Raison Federico Ambrogi Serena Delbue Maria Chiara Clementi luca lamperti Marta Perego Matteo Bischeri Mariano Ferraresso Renal Transplantation Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20100Italy

BACKGROUND To date,there are no guidelines on the treatment of solid neoplasms in the transplanted ***,allograft nephrectomy has been considered the only reasonable *** recently,nephron-sparing surgery (NSS) and ablative therapy (AT) have been proposed as alternative procedures in selected *** To review outcomes of AT for the treatment of renal allograft *** We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 *** was searched in March 2019 without time restrictions for all papers reporting on radiofrequency ablation (RFA),cryoablation (CA),microwave ablation (MWA),high-intensity focused ultrasound (HIFU),and irreversible electroporation (IRE) of solid tumours of the kidney *** original manuscripts describing actual cases and edited in English were *** relevant articles were accessed in full *** searches included all pertinent *** studies were also assessed for methodological quality using a tool based on a modification of the Newcastle Ottawa *** on recipient characteristics,transplant characteristics,disease characteristics,treatment protocols,and treatment outcomes were extracted and *** the nature and the quality of the studies available (mostly retrospective case reports and small retrospective uncontrolled case series),a descriptive summary was *** Twenty-eight relevant studies were selected describing a total of 100 AT procedures in 92 *** age at diagnosis ranged from 21 to 71 years whereas time from transplant to diagnosis ranged from 0.1 to 312 *** of the neoplasms were asymptomatic and diagnosed incidentally during imaging carried out for screening purposes or for other clinical *** diagnostic modality was Doppler-ultrasound scan followed by computed tomography scan,and magnetic resonance *** tumour types were: pa

关键词： Ablative therapy Cryoablation Radiofrequency ablation Microwave ablation High-intensity focused ultrasonography Irreversible electroporation Neoplasm Kidney transplant Renal allograft Systematic review

Treatment options for localised renal cell carcinoma of the transplanted kidney

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World Journal of Transplantation 2020年第6期10卷 147-161页

作者： Gloria Motta Mariano Ferraresso luca lamperti Dhanai Di Paolo Nicholas Raison Marta Perego Evaldo Favi Urology IRCCS Policlinico San DonatoSan Donato Milanese 27288Italy Renal Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilan 20122Italy Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom

Currently,there is no consensus among the transplant community about the treatment of renal cell carcinoma(RCC)of the transplanted *** recently,graftectomy was universally considered the golden standard,regardless of the characteristics of the *** to the encouraging results observed in native kidneys,conservative options such as nephron-sparing surgery(NSS)(enucleation and partial nephrectomy)and ablative therapy(radiofrequency ablation,cryoablation,microwave ablation,high-intensity focused ultrasound,and irreversible electroporation)have been progressively used in carefully selected recipients with early-stage allograft *** reports show excellent patient survival,optimal oncological outcome,and preserved renal function with acceptable complication ***,the rarity and the heterogeneity of the disease,the number of options available,and the lack of long-term follow-up data do not allow to adequately define treatment-specific advantages and *** role of active surveillance and immunosuppression management remain also *** order to offer a better insight into this difficult topic and to help clinicians choose the best therapy for their patients,we performed and extensive review of the *** focused on epidemiology,clinical presentation,diagnostic work up,staging strategies,tumour characteristics,treatment modalities,and follow-up *** research confirms that both NSS and focal ablation represent a valuable alternative to graftectomy for kidney transplant recipients with American Joint Committee on Cancer stage T1aN0M0 *** on T1bN0M0 lesions are scarce but suggest extra *** designed multi-centre prospective clinical trials are warranted.

关键词： Renal cell carcinoma Kidney transplant Graftectomy Nephron-sparing surgery Focal ablation Review

Large-area patterning of substrate-conformal MoS2 nano-trenches

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Nano Research 2019年第8期12卷 1851-1854页

作者： Christian Martella luca Ortolani Elena Cianci Alessio lamperti Vittorio Morandi Alessandro Molle IMM-CNR via C. Olivetti 2Agrate Brianza (MB) 1-20864Italy ISC-CNR U.O.S. SapienzaRoma 1-00185Italy IMM-CNR via Gobetti 101Bologna (BO) 1-40129Italy

Within the class of two-dimensional materials, transition metal dichalcogenides (TMDs), are extremely appealing for a variety of technological applications. Moreover, the manipulation of the layered morphology at the nanoscale is a knob for further tailoring their physical and chemical properties towards target applications. Here, the combination of atomic layer deposition (ALD) and chemical vapour deposition (CVD) is presented as a general approach for the fabrication of TMD layers arranged in arbitrary geometry at the nanoscale. Indeed, following such all-chemical based approach, high-resolution electron microscopy shows the conformal growth of MoS2 to nano-trench pattern obtained in SiO2 substrates on large area. Growth is uniform not only in the flat region of the pattern but also at the hinges and throughout vertical faces, without rupture, all along the rectangular shape profile of the trenches. Furthermore, MoS2 bending dramatically affects the electron-phonon coupling as demonstrated by resonant Raman scattering. The proposed approach opens the door to the on-demand manipulation of the TMDs properties by large-scale substrate pattern design.

关键词： two-dimensional (2D) materials transition metal dichalcogenides nano-trenches conformal growths high-resolution electron microscopy