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Robot-assisted trans-gastric drainage and debridement of walled-off pancreatic necrosis using the EndoWrist stapler for the da Vinci Xi:A case report

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World Journal of Clinical Cases 2019年第12期7卷 1461-1466页

作者： Luca Morelli Niccolò Furbetta Desirée Gianardi matteo palmeri Gregorio Di Franco matteo Bianchini Gianni Stefanini Simone Guadagni Giulio Di Candio General Surgery Unit Department of Translational Research and New Technologies in Medicine and Surgery University of Pisa Pisa 56124 Italy EndoCAS (Center for Computer Assisted Surgery) University of Pisa Pisa 56124 Italy

BACKGROUND Walled-off pancreatic necrosis (WOPN) is a late complication of acute pancreatitis. The management of a WOPN depends on its location and on patient's symptoms. Trans-gastric drainage and debridement of WOPN represents an important surgical treatment option for selected patients. The da Vinci surgical System has been developed to allow an easy, minimally invasive and fast surgery, also in challenging abdominal procedures. We present here a case of a WOPN treated with a robotic trans-gastric drainage using the da Vinci Xi. CASE SUMMARY A 63-year-old man with an episode of acute necrotizing pancreatitis was referred to our center. Six wk after the acute episode the patient developed a walled massive fluid collection, with an extensive pancreatic necrosis, causing obstruction of the gastrointestinal tract. The patient underwent a robotic transgastric drainage and debridement of the WOPN performed with the da Vinci Xi platform. Firstly, an anterior ideal gastrotomy was carried out, guided by intraoperative ultrasound (US)-scan using the TilePro? function. Then, through the gastrotomy, the best location for drainage on the posterior gastric wall was again US-guided identified. The anastomosis between the posterior gastric wall and the walled-off necrosis wall was carried out with the new EndoWrist stapler with vascular cartridge. Debridement and washing of the cavity through the anastomosis were performed. Finally, the anterior gastrotomy was closed and the cholecystectomy was performed. The postoperative course was uneventful and a post-operative computed tomography-scan showed the collapse of the fluid collection. CONCLUSION In selected cases of WOPN the da Vinci Surgical System can be safely used as a valid surgical treatment option.

关键词： Case report da Vinci Xi EndoWrist stapler Walled-off pancreatic necrosis TilePro Minimally-invasive surgery

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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

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The interplay of drug therapeutics and immune responses to SARS-CoV-2

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Cellular & Molecular Immunology 2024年第2期21卷 197-200页

作者： Valeria Fumagalli matteo Iannacone Division of Immunology Transplantationand Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilanItaly Vita-Salute San Raffaele University MilanItaly Experimental Imaging Centre IRCCS San Raffaele Scientific InstituteMilanItaly

The SARS-CoV-2 pandemic has necessitated rapid therapeutic and preventative *** vaccines form the frontline of defense,antiviral treatments such as nirmatrelvir have emerged as vital adjunctive measures,particularly for those unable or unwilling to be *** review delves into the potential influence of nirmatrelvir on enduring *** parallel,the potential of drug repurposing is explored,with bisphosphonates being examined for their possible effects against COVID-19 due to their immunomodulatory *** importance of rigorous clinical trials and careful interpretation of preliminary data is emphasized.

关键词： SARS-CoV-2 Nirmatrelvir Bisphosphonates Adaptive immunity Drug repurposing

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Recent Advances in the Synthesis and Polymerization of New CO_(2)-Based Cyclic

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Chinese Journal of Chemistry 2024年第4期42卷 430-443页

作者： matteo Lanzi Arjan W.Kleij Institute of Chemical Research of Catalonia(ICIQ) The Barcelona Institute of Science and Technology(BIST)Av.Països Catalans 1643007 TarragonaSpain Catalan Institute of Research and Advanced Studies(ICREA) Pg.Lluís Companys 2308010 BarcelonaSpain

Carbon dioxide can be converted into functional heterocycles known as cyclic carbonates,whose recent reactivity has been expanded towards the formation of tailor-made engineering *** minireview gives an overview of the most topical developments in this area with a special focus on the synthetic methods employed to prepare these CO_(2)based *** addition,their application potential in the area of polymer science using a variety of polymerization techniques is discussed that have in common the ring-opening of the carbonate *** perspectives are provided that provide impetus for the scientific communities aligning research to the use of sustainable processes for polymers from recyclable carbon sources such as CO_(2).

关键词： Carbon dioxide Cyclic carbonates Functional macromolecules Heterocycles Polycarbonates Recycling Ring opening polymerization

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Use of zebrafish embryos as avatar of patients with pancreatic cancer:A new xenotransplantation model towards personalized medicine

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World Journal of Gastroenterology 2020年第21期26卷 2792-2809页

作者： Gregorio Di Franco Alice Usai Niccola Funel matteo palmeri Ida Elena Rosamaria Montesanti matteo Bianchini Desirée Gianardi NiccolòFurbetta Simone Guadagni Enrico Vasile Alfredo Falcone Luca Emanuele Pollina Vittoria Raffa Luca Morelli General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Department of Biology University of PisaPisa 56127Italy Division of Surgical Pathology Department of Laboratory of MedicineHospital-University of PisaPisa 56124Italy Division of Medical Oncology Pisa University HospitalPisa 56124Italy Department of Translational Research and New Technologies in Medicine and Surgery University of PisaPisa 56124Italy EndoCAS(Center for Computer Assisted Surgery) University of PisaPisa 56124Italy

BACKGROUND The response to chemotherapy treatment of patients with pancreatic ductal adenocarcinoma(PDAC)is difficult to predict and the identification of patients who most likely will benefit from aggressive chemotherapy approaches is *** concept of personalized medicine has emerged in the last years with the objective to tailor the medical treatment to the individual characteristics of each patient,and particularly to the tumor biology of each *** need for invivo xenotransplantation models for cancer patients has increased exponentially,and for this reason zebrafish avatars have gained *** studies were conducted also with PDAC *** To develop a simple,not expensive,diffusible zebrafish embryo model as avatar for patients affected by *** Tumor tissue was taken from the surgical specimen by the *** its fragmentation into small pieces,they are stained with *** pieces of stained tissue were transplanted into the yolk of wt AB zebrafish embryos with a glass capillary *** were incubated at 35°C in E3 medium supplemented with 1%Pen/Strep in the presence or absence of drugs for the following days in respect of the treatment plan(Gemcitabine;Gemcitabine and Oxaliplatin;Gemcitabine and nab-Paclitaxel;5-Fluorouracil and Folinic acid and Oxaliplatin and Irinotecan).The response of zebrafish xenografts to the chemotherapy options has been analyzed by monitoring the fluorescent stained area at 2 h post injection(hpi),1 d and 2 d post injection(dpi).In each time point,the mean size of the stained area was measured by ImageJ and it was normalized with respect to the 1 dpi time point mean relative tumor area(RTA).We evaluated the effect of the chemotherapy exposition comparing the mean RTA of each treated subgroup and the control group and evaluating the percentage reduction of the mean RTA by comparing each treated subgroup with the control *** Between July 2018 and October 2019,a t

关键词： Pancreatic ductal adenocarcinoma Zebrafish embryos Personalized medicine Xenotransplantation Chemotherapy efficacy Avatar of oncological patients

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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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Janus-faced Mitofusin 2 (MFN2): mitochondria-endoplasmic reticulum shaping and tethering functions unveiled

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Signal Transduction and Targeted Therapy 2024年第2期9卷 341-342页

作者： Camilla Aurora Franchino Elisa Motori matteo Bergami Institute for Biochemistry University of Cologne50674 CologneGermany Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases(CECAD) Faculty of Medicine and University Hospital CologneUniversity of Cologne50931 CologneGermany Center for Molecular Medicine 50931 CologneGermany

In a recently published study in Science,Naòn et *** two uncharacterized splice variants of Mitofusin 2(MFN2)that specifically shape and tether the endoplasmic reticulum(ER)to mitochondria.1 This work sheds new light on the pleiotropic effects previously ascribed to MFN2 loss-of-function mutations,and has important implications for associated metabolic and neurological diseases.

关键词： MFN2 reticulum

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Prevention of hepatitis B reactivation in patients with hematologic malignancies treated with novel systemic therapies:Who and Why?

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World Journal of Gastroenterology 2024年第5期30卷 509-511页

作者： matteo Tonnini Clara Solera Horna Luca Ielasi Department of Medical and Surgical Sciences University of BolognaBologna 40138Italy Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Infectious Disease Unit Azienda USL-IRCCS di Reggio EmiliaReggio Emilia 42123Italy Department of Internal Medicine Ospedale degli Infermi di FaenzaFaenza 48018Italy

The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown *** indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed *** the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular *** novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be ***,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is *** results are now available,but further studies are still *** with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all ***/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.

关键词： Hepatitis B reactivation Hepatitis B virus Antiviral prophylaxis Hematologic malignancies Chimeric antigens receptor-T cell therapy Immune checkpoint inhibitors

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Role of abdominal ultrasound for the surveillance follow-up of pancreatic cystic neoplasms: a cost-effective safe alternative to the routine use of magnetic resonance imaging

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World Journal of Gastroenterology 2019年第18期25卷 2217-2228页

作者： Luca Morelli Simone Guadagni Valerio Borrelli Roberta Pisano Gregorio Di Franco matteo palmeri Niccolò Furbetta Dario Gambaccini Santino Marchi Piero Boraschi Luca Bastiani Alessandro Campatelli Franco Mosca Giulio Di Candio General Surgery Unit Department of Surgery Translational and New Technologies in Medicine University of Pisa EndoCAS (Center for Computer Assisted Surgery) University of Pisa Diagnostic and Interventional Ultrasound in Transplants Unit Azienda Ospedaliero-Universitaria Pisana Gastroenterology Unit University of Pisa 2~(nd) Radiology Unit Department of Diagnostic Imaging Azienda Ospedaliero-Universitaria Pisana Institute of Clinical Physiology National Council of Research

BACKGROUND Patients with pancreatic cystic neoplasms(PCN), without surgical indication at the time of diagnosis according to current guidelines, require lifetime imagebased surveillance follow-up. In these patients, the current European evidencedbased guidelines advise magnetic resonance imaging(MRI) scanning every 6 mo in the first year, then annually for the next five years, without reference to any role for trans-abdominal ultrasound(US). In this study, we report on our clinical experience of a follow-up strategy of image-based surveillance with US, and restricted use of MRI every two years and for urgent evaluation whenever suspicious changes are detected by *** To report the results and cost-efficacy of a US-based surveillance follow-up for known PCNs, with restricted use of *** We retrospectively evaluated the records of all the patients treated in our institution with non-surgical PCN who received follow-up abdominal US and restricted MRI from the time of diagnosis, between January 2012 and January 2017. After US diagnosis and MRI confirmation, all patients underwent US surveillance every 6 mo for the first year, and then annually. A MRI scan was routinely performed every 2 years, or at any stage for all suspicious US *** this communication, we reported the clinical results of this alternative followup, and the results of a comparative cost-analysis between our surveillance protocol(abdominal US and restricted MRI) and the same patient cohort that has been followed-up in strict accordance with the European guidelines recommended for an exclusive MRI-based surveillance *** In the 5-year period, 200 patients entered the prescribed US-restricted MRI surveillance follow-up. Mean follow-up period was 25.1 ± 18.2 mo. Surgery was required in two patients(1%) because of the appearance of suspicious features at imaging(with complete concordance between the US scan and the on-demand MRI). During the follow-up, US revealed changes in PCN

关键词： Ultrasound Pancreatic cystic neoplasms Magnetic resonance imaging Surveillance

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Detailing the ultrastructure’s increase of prion protein in pancreatic adenocarcinoma

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World Journal of Gastroenterology 2021年第42期27卷 7324-7339页

作者： matteo Bianchini Maria Anita Giambelluca Maria Concetta Scavuzzo Gregorio Di Franco Simone Guadagni matteo palmeri NiccolòFurbetta Desirée Gianardi Niccola Funel Claudio Ricci Raffaele Gaeta Luca Emanuele Pollina Alfredo Falcone Caterina Vivaldi Giulio Di Candio Francesca Biagioni Carla Letizia Busceti Luca Morelli Francesco Fornai General Surgery Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Human Anatomy Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy Division of Surgical Pathology Department of SurgicalMedicalMolecular Pathology and Critical AreaUniversity of PisaPisa 56124Italy Division of Medical Oncology Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56124Italy IRCCS Neuromed Istituto Neurologico MediterraneoPozzilli 86077Italy EndoCAS(Center for Computer Assisted Surgery) University of PisaPisa 56124Italy

BACKGROUND Recent evidences have shown a relationship between prion protein(PrPc)expression and pancreatic ductal adenocarcinoma(PDAC).Indeed,PrPc could be one of the markers explaining the aggressiveness of this ***,studies investigating the specific compartmentalization of increased PrPc expression within PDAC cells are lacking,as well as a correlation between ultrastructural evidence,ultrastructural morphometry of PrPc protein and clinical *** data,as well as the quantitative stoichiometry of this protein detected by immuno-gold,provide a significant advancement in understanding the biology of disease and the outcome of surgical *** To analyze quantitative stoichiometry and compartmentalization of PrPc in PDAC cells and to correlate its presence with prognostic data METHODS Between June 2018 and December 2020,samples from pancreatic tissues of 45 patients treated with pancreatic resection for a preoperative suspicion of PDAC at our Institution were *** the frozen section excluded a PDAC diagnosis,or the nodules were too small for adequate sampling,patients were ruled out from the present *** blotting was used to detect,quantify and compare the expression of PrPc in PDAC and control tissues,such as those of non-affected neighboring pancreatic tissue of the same *** quantify the increase of PrPc and to detect the subcellular compartmentalization of PrPc within PDAC cells,immuno-gold stoichiometry within specific cell compartments was analyzed with electron ***,an analysis of quantitative PrPc expression according to prognostic data,such as cancer stage,recurrence of the disease at 12 mo after surgery and recurrence during adjuvant chemotherapy was *** The amount of PrPc within specimen from 38 out of 45 patients was determined by semi-quantitative analysis by using Western blotting,which indicates that PrPc increases almost three-fold in tumor pancreatic tissue compared with healthy panc

关键词： Pancreatic ductal adenocarcinoma Prion protein Western blotting Electron microscopy Cellular compartmentalization Neuroinvasion

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