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Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safety

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World Journal of Gastroenterology 2007年第28期13卷 3861-3863页

作者： Ilaria Tarantino luca Barresi Marta di Pisa Mario Traina Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione University of Pittsburgh Medical CenterItaly

AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP) performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients. METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters: indication for FNA, EUS findings, pathological diagnosis, procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications. RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction, and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy. CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.

关键词： Pancreatic mass Endoscopic ultrasound fine needle aspiration Biliary stent Jaundice Endoscopictherapy

Gastric endoscopic submucosal dissection in Western countries:Indications,applications,efficacy and training perspective

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1180-1189页

作者： luca De luca Massimiliano di Berardino Benedetto Mangiavillano Alessandro Repici Gastroenterology and digestive Endoscopy Unit Riuniti Marche North HospitalPesaro 61121Italy Gastrointestinal Endoscopy Unit Humanitas-Mater DominiCastellanza 21053Italy digestive Endoscopy Unit Humanitas Clinical and Research CenterHumanitas UniversityRozzano 20089Italy

Endoscopic submucosal dissection was introduced in Japan for the mini-invasive treatment of early gastric cancer,as part of national screening program considering high prevalence of disease in these *** technique allows en-bloc curative oncological excision and to obtain in a single step R0-resection,characterization,histological staging and potential cure of the tumor with a very high cost-benefit *** the years,Western endoscopists have adopted endoscopic submucosal dissection,achieving good rates of efficacy,long-term improved outcomes and safety,with low risk of local recurrence comparable to those obtained in Asian ***,according to some authors,the excellent outcomes from East country could not be representative of the Western *** epidemiological differences of early gastric cancer,scant volume data and limitations in training opportunities between Western and Eastern countries,European Society of Gastrointestinal Endoscopy have adopted Japanese guidelines and developed a European core curriculum for endoscopic submucosal dissection *** should be able to estimate the probability of performing a curative resection by considering the benefit/risk relationship case-by-case in order to implement a correct decision-making process.

关键词： Endoscopic submucosal dissection Western experience Early gastric cancer Curative oncological excision Long-term outcome Training perspective

Final results of the first phase of the PROTO-SPHERA experiment: obtainment of the full current stable screw pinch and first evidences of the jet + torus combined plasma configuration

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Plasma Science and Technology 2024年第2期26卷 31-43页

作者： Paolo MICOZZI Franco ALLAdiO Alessandro MANCUSO Vincenzo ZANZA Gerarda APRUZZESE Francesca BOMBARDA luca BONCAGNI Paolo BURATTI Francesco FILIPPI Giuseppe GALATOLA TEKA Francesco GIAMMANCO Edmondo GIOVANNOZZI Andrea GROSSO Matteo IAFRATI Alessandro LAMPASI Violeta LAZIC Simone MAGAGNINO Simone MANNORI Paolo MARSILI Valerio PIERGOTTI Giuliano ROCCHI Alessandro SIBIO Benedetto TILIA Onofrio TUdiSCO FSN dipartimento Fusione e tecnologie per la Sicurezza Nucleare ENEA Agenzia Nazionale per Le Nuove Tecnologie Energia e lo Sviluppo Economico SostenibileFrascati(Rome)00044Italy IAPS Istituto di Astrofisica e Planetologia Spaziali INAF Istituto Nazionale di AstrofisicaRome O133Italy Physics Department University of Pisa Faculty of Natural Sciences Mathematics and PhysicsPisa 56127 Italy

In astrophysics, the boundary conditions for plasma phenomena are provided by nature and the astronomer faces the problem of understanding them from a variety of observations [Hester J J et al 1996 Astrophys. J. 456 225], on the other hand, in laboratory plasma experiments the electromagnetic boundary conditions become a major problem in the set-up of the machine that produces the plasma, an issue that has to be investigated step by step and to be modified and adapted with great patience, in particular in the case of an innovative plasma confinement experiment. The PROTO-SPHERA machine [Alladio F et al 2006 Nucl. Fusion 46 S613] is a magnetic confinement experiment, that emulates in the laboratory the jet + torus plasma configurations often observed in astrophysics: an inner magnetized jet of plasma centered on the(approximate) axis of symmetry and surrounded by a magnetized plasma torus orthogonal to this jet. The PROTO-SPHERA plasma is simply connected, i.e., no metal current conducting rod is linked to the plasma torus, while instead it is the inner magnetized plasma jet(in the following always called the plasma centerpost) that is linked to the torus. It is mandatory that no spurious plasma current path modifies the optimal shape of the plasma centerpost. Moreover, as the plasma torus is produced and sustained, in absence of any applied inductive electric field, by the inner plasma centerpost through magnetic reconnections [Taylor J B and Turner M F 1989 *** 29 219], it is required as well that spurious current paths do not surround the torus on its outboard, in order not to lower the efficiency of the magnetic reconnections that maintain the plasma torus at the expense of the plasma centerpost. Boundary conditions have been corrected,up to the point that the first sustainment in steady state has been achieved for the combined plasma.

关键词： laboratory plasmas magnetic confinement astrophysical plasmas

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

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Asian Journal of Urology 2024年第2期11卷 271-279页

作者： Andrea Cocci Marta Pezzoli Fernando Bianco Franco Blefari Pierluigi Bove Francois Cornud Gaetano De Rienzo Paolo Destefanis Danilo di Trapani Alessandro Giacobbe luca Giovanessi Antonino Laganà Giovanni Lughezzani Guglielmo Manenti Gianluca Muto Gianluigi Patelli Novello Pinzi Stefano Regusci Giorgio I.Russo Juan I.M.Salamanca Matteo Salvi Luigi Silvestri Fabrizio Verweij Eric Walser Riccardo GBertolo Valerio Iacovelli Alessandro Bertaccini Debora Marchiori Hugo Davila Pasquale ditonno Paolo Gontero Gennaro Iapicca Theo M De Reijke Vito Ricapito Pierluca Pellegrini Andrea Minervini Sergio Serni Francesco Sessa Department of Urology Careggi HospitalUniversity of FlorenceFlorenceItaly Urology Section University of FlorenceFlorenceItaly Urological Research Network MiamiFLUSA Urology Section Prato HospitalPratoItaly Torvergata Oncoscience Research Centre of Excellence TORDepartment of Experimental MedicineUniversity of Rome Tor VergataRomeItaly Department of Urology San Carlo di Nancy HospitalRomeItaly Department of Radiology Hôpital CochinParis Descartes UniversityParisFrance Urology and Andrology Unit II Department of Emergency and Organ TransplantationUniversity of BariBariItaly Unit of Urology Cittàdella Salute e della Scienza HospitalUniversity of TurinTurinItaly Urology Unit Buccheri La Ferla Fatebenefratelli HospitalPalermoItaly Department of Urology Humanitas Gradenigo HospitalTurinItaly Urology Unit Surgical DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly Departement of Urology “S.Giovanni Evangelista”HospitalTivoliItaly Humanitas Clinical and Research CentereIRCCS Department of UrologyRozzanoItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly Department of Biomedicine and Prevention University of Rome“Tor Vergata”RomeItaly Department of diagnostic Imaging and Interventional Radiology University of Rome“Tor Vergata”RomeItaly Department of Interventional Radiology Pesenti-Fenaroli Hospital-ASST Bergamo EstAlzano LombardoItaly Department of Urology University of SienaSienaItaly Swiss International Prostate Center GenevaSwitzerland Clinique Générale Beaulieu GenevaSwitzerland Department of Urology University of CataniaItaly Department of Urology Puerta de Hierro-Majadahonda University HospitalMadridSpain Lyx Institute of Urology Universidad Francisco de VitoriaMadridSpain Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of RomeFaculty of Pharmacy and MedicineUrology Unit ICOTLatinaItaly Department of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Department of Radiology D

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus ***: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and ***: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading t

关键词： Transperineal laser ablation Prostatecancer Benignprostatic hyperplasia Delphi consensus

Trauma-induced“Macklin effect”with pneumothorax and large pneumomediastinum,disguised by allergy

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Frontiers of Medicine 2013年第3期7卷 386-388页

作者： Salomone di Saverio Kenji Kawamukai Andrea Biscardi Silvia Villani luca Zucchini Gregorio Tugnoli Departments of Emergency and Surgery Emergency Surgery and Trauma Surgery UnitTrauma CenterMaggiore Hospital-Bologna Local Health DistrictBolognaItaly Department of Thoracic Surgery Trauma CenterMaggiore HospitalBolognaItaly Accident and Emergency Trauma CenterMaggiore HospitalBolognaItaly

A 56-year-old man presented spontaneously to the Emergency Department complaining of facial and neck oedema after assumption of nonsteroidal anti-inflammatory drugs(NSAIDS).The triage nurse assigned the patient to Accident&Emergency(A&E)doctor as probable allergic reaction to *** X-ray(CXR),ordered after 24 hours,revealed a huge subcutaneous chest and neck emphysema without clearly visible *** chest CT scan showed a small left pneumothorax and a large amount of air in the *** patient was conservatively treated since he was eupnoeic and hemodynamically *** pathophysiology of pneumomediastinum was first described by Macklin in *** Macklin effect involves alveolar ruptures with air dissection along bronchovascular sheaths to the *** this case the patient did not report in his history a recent blunt thoracic trauma and the initial suspicion of an allergic reaction has prevented physicians to immediately achieve the correct diagnosis.

关键词： thoracic trauma differential diagnosis critical care pneumothorax pneumomediastinum CT scan pitfalls lung and airways physiology

Atypical presentation of pioderma gangrenosum complicating ulcerative colitis: Rapid disappearance with methylprednisolone

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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

Foveal avascular zone area and parafoveal vessel density measurements in different stages of diabetic retinopathy by optical coherence tomography angiography

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International Journal of Ophthalmology(English edition) 2017年第10期10卷 1545-1551页

作者： Rodolfo Mastropasqua Lisa Toto Alessandra Mastropasqua Raffaella Aloia Chiara De Nicola Peter A Mattei Guido di Marzio Marta di Nicola luca di Antonio Ophthalmology Clinic University of Marche Ophthalmology Clinic Department of Medicine and Science of AgeingUniversity G.d'Annunzio Chieti-Pescara Department of Experimental and Clinical Sciences Laboratory of BiostatisticsUniversity G.d'Annunzio Chieti-Pescara

AIM：To investigate foveal avascular zone（FAZ）and parafoveal vessel densities（PRVD）by means of optical coherence tomography angiography（OCTA）in diabetic patients with or without diabetic retinopathy（DR）and to assess the reproducibility of FAZ and PRVD ***：Sixty diabetic patients（60 eyes）with different stage of DR（graded according to the International Clinical Severity Scale for DR）and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced *** area in all patients was also assessed using fluorescein angiography（FA）.RESULTS：In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls（P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA）.OCTA showed significantly less inter-observer variability compared to *** correlation coefficient（CCC）for FAZ area measurements was 0.829（95%CI：0.736-0.891）P〈0.001 with FA and 1.000（95%CI：0.999-1.000）P〈0.001with *** was 0.834（95%CI：0.746-0.893）P〈0.001and 0.890（95%CI：0.828-0.930）P〈0.001 for parafoveal superficial and deep vessel density measurements,***：OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR *** area and PRVD measurements using OCTA are highly reproducible.

关键词： optical coherence tomography angiography diabetic retinopathy fluorescein angiography

Helicobacter pylori-negative Russell body gastritis:Case report

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World Journal of Gastroenterology 2011年第9期17卷 1234-1236页

作者： Alessandro Del Gobbo luca Elli Paola Braidotti Franca di Nuovo Silvano Bosari Solange Romagnoli Department of Medicine Surgery and DentistryDivision of PathologyA.O.San Paolo and Fondazione IRCCS Cà-Granda Ospedale Maggiore PoliclinicoUniversity of Milan Medical School Center for Prevention and diagnosis of Celiac disease Fondazione IRCCS Cà-Granda Ospedale Maggiore PoliclinicoUniversity of Milan Pathology Unit A.O.G.Salvini20024 Garbagnate MilaneseItaly

Russell body gastritis is an unusual form of chronic gastritis characterized by the permeation of lamina propria by numerous plasma cells with eosinophilic cytoplasmic *** few cases have been reported in the literature;the majority of which have shown Helicobacter Pylori(***)infection,thus suggesting a correlation between plasma cell presence and antigenic stimulation by *** present a case of Russell body gastritis in a 78-year-old woman who was undergoing esophagogastroduodenoscopy for epigastric *** biopsy of the gastroesophageal junction showed the presence of cells with periodic acid-Schiff-positive hyaline pink *** staining for *** infection was nega-tive,as well as immunohistochemical *** cells with eosinophilic inclusions stained positive for CD138,CD79a,andκand lambda light chains,which confirmed plasma cell *** particular,κand lambda light chains showed a polyclonal origin and the patient was negative for immunological *** histological observations were confirmed by ultrastructural *** cases reported in the literature associated with *** infection have shown regression of plasma cells after eradication of *** is known about the progression of ***-negative *** unusual morphological appearance of this type of chronic gastritis should not be misinterpreted during routine examination,and it should be distinguished from other common forms of chronic *** is mandatory to exclude neoplastic diseases such as gastric carcinoma, lymphoma and plasmocytoma by immunohistochemistry and electron microscopy,which can help with differential *** long-term effects of plasma cells hyperactivation are still unknown,because cases of gastric tumor that originated in patients affected by Russell body gastritis have not been described in the *** are of the opinion that these patients should be scheduled for endoscopic surveillance.

关键词： Russell body Gastritis Helicobacter Pylori Plasma cells Crystalline inclusions

Tissue microarray-chip featuring computerized immunophenotypical characterization more accurately subtypes ampullary adenocarcinoma than routine histology

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World Journal of Gastroenterology 2020年第43期26卷 6822-6836页

作者： Matteo Palmeri Niccola Funel Gregorio di Franco Niccolo Furbetta Desiree Gianardi Simone Guadagni Matteo Bianchini luca E Pollina Claudio Ricci Marco Del Chiaro Giulio di Candio luca Morelli General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy division of Surgical Pathology University-Hospital of PisaPisa 56124Italy Department of Surgical MedicalMolecular Pathology and Critical AreaUniversity of PisaPisa 56124Italy Department of Surgery University of ColoradoDenverCO 80045United States

BACKGROUND Ampullary adenocarcinomas(AACs)are heterogeneous tumors currently classified into three important sub-classes(SC):Intestinal(INT),Pancreato-Biliary(PB)and Mixed-Type(MT).The different subgroups have similar clinical presentation and are treated by pancreatoduodenectomy with curative ***,they respond differently to chemotherapy and have different prognostic *** SC are often difficult to identify with conventional histology *** clinical outcome of all three remains unclear,particularly for *** To identify two main subtypes of AACs,using an immunohistochemical(IHC)score based on CDX2,CK7 and *** Tissue samples from 21 patients who had undergone resection of AAC were classified by HE histology and IHC expression of CDX2,CK7 and CK *** IHC score was obtained for each marker by counting the number of positive cells(0=no stained cells;150%)and their intensity(1=weak;2=moderate and 3=strong).A global score(GS)was then obtained by summation of the IHC scores of each *** MT tumors were grouped either with the INT or PB group based on the predominant immuno-molecular phenotype,obtaining only two AACs *** overall survival in INT and PB patients was obtained by Kaplan-Meier *** Histological parameters defined the AACs subtypes as follows:15%INT,45%PB and 40%*** IHC expression and the GS,75%and 25%of MT samples were assigned to either the INT or the PB *** mean value of the GS was 9.5(range 4-16).All INT samples had a GS above the average,distinct from the PB samples which had a GS score significantly below the average(P=0.0011).The INT samples were identified by high expression of CDX2 and CK20,whereas PB samples exhibited high expression of CK7 and no expression of CK20(P=0.0008).The INT group had a statistically significant higher overall survival than in the PB group(85.7 mo vs 20.3 mo,HR:8.39;95%CI:1.38 to 18.90;P=0.0152).CONCLUSION The combination of histopathological a

关键词： Ampullary adenocarcinoma Histo-molecular phenotype Prognostic CK7 CK20 CDX2