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Massive bleeding from gastric submucosal arterial collaterals secondary to splenic artery thrombosis: A case report

World Journal of Gastroenterology 2022年第37期28卷 5506-5514页

作者： Alberto Martino Marco Di Serafino Francesco Paolo Zito Franco Maglione Raffaele Bennato Luigi Orsini Alessandro Iacobelli Raffaella Niola Luigia Romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Radiology Sanatrix ClinicNapoli 80127Italy Department of Pathology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Interventional Radiology AORN“Antonio Cardarelli”Napoli 80131Italy

BACKGROUND Gastric submucosal arterial collaterals(GSAC)secondary to splenic artery occlusion is an extraordinary rare and potentially life-threatening cause of acute upper gastrointestinal ***,we report a case of massive bleeding from GSAC successfully treated by means of a multidisciplinary minimally invasive *** SUMMARY A 60-year-old non-cirrhotic gentleman with a history of arterial hypertension was admitted due to *** esophagogastroduodenoscopy revealed pulsating and tortuous varicose shaped submucosal vessels in the gastric fundus along with a small erosion overlying one of the *** order to characterize the fundic lesion,pre-operative emergent computed tomography-angiography was performed showing splenic artery thrombosis(SAT)and tortuous arterial structures arising from the left gastric artery and the left gastroepiploic artery in the gastric *** was successfully treated by means of a minimally invasive step-up approach consisting in endoscopic clipping followed by transcatheter arterial embolization(TAE).CONCLUSION This was a previously unreported case of bleeding GSAC secondary to SAT successfully managed by means of a multidisciplinary minimally invasive approach consisting in endoscopic clipping for the luminal bleeding control followed by elective TAE for the definitive treatment.

关键词： Upper gastrointestinal bleeding Non variceal upper gastrointestinal bleeding Acute upper gastrointestinal bleeding Gastric submucosal arterial collaterals Splenic artery thrombosis Case report

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Helicobacter pylori infection in bleeding peptic ulcer patients after non-steroidal antiinflammatory drug consumption

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World Journal of Gastroenterology 2011年第40期17卷 4509-4516页

作者： Francesco Manguso Elisabetta Riccio Germana de Nucci Maria Luisa Aiezza Gerardino Amato Linda Degl'Innocenti Maria Maddalena Piccirillo Gianfranco De Dominicis Tara Santoro Elena Trimarco Antonio Balzano Complex Operating Unit of Gastroenterology aorn A cardarelli 80131 Napoli Italy Complex Operating Unit of Pharmacy aorn A cardarelli 80131 Napoli Italy Complex Operating Unit of Microbiology aorn A cardarelli 80131 Napoli Italy Complex Operating Unit of Pathology aorn A cardarelli 80131 Napoli Italy

AIM： TO establish the prevalence of He/icobacterpy/on （H. pylori） infection in patients with a bleeding peptic ulcer after consumption of non-steroidal antiinflammatory drugs （NSAIDs）.METHODS： A very early upper endoscopy was performed to find the source of upper gastrointestinal bleeding and to take biopsy specimens for analysis of H. pylori infection by the rapid urease （CLO） test, his- tological examination, and bacterial culture. TgG anti- CagA were also sought. The gold standard for identifying H. pylori infection was positive culture of biopsy specimens or contemporary positivity of the CLO test and the presence of H. pylori on tissue ***： Eighty patients, 61 males （76.3%）, mean age 61.2 ~ 15.9 years, were consecutively enrolled. Forty-seven （58.8%） patients occasionally consumed NSAIDs, while 33 （41.3%） were on chronic treatment with low-dose aspirin （LD ASA）. Forty-four （55.0%） patients were considered infected by H. pylori. The infection rate was not different between patients who occasionally or chronically consumed NSAIDs. The culture of biopsy specimens had a sensitivity of 86.4% and a specificity of 100%; corresponding figures for histological analysis were 65.9% and 77.8%, for the CLO test were 68.2% and 75%, for the combined use of histology and the CLO test were 56.8% and 100%, and for IgG anti-CagA were 90% and 98%. The high- est accuracy （92.5%） was obtained with the culture of biopsy ***： Patients with a bleeding peptic ulcer after NSAID/LD ASA consumption frequently have H. pylori infection. Biopsy specimen culture after an early upper gastrointestinal tract endoscopy seems the most efficient test to detect this infection.

关键词： Helicobacter pylori Helicobacter pylori in-fection Low-dose aspirin Non-steroidal antiinflamma-tory drugs Peptic ulcer hemorrhage Endoscopy

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Acute upper gastrointestinal bleeding caused by esophageal right bronchial artery fistula:A case report

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World Journal of Gastrointestinal Endoscopy 2021年第11期13卷 565-570页

作者： Alberto Martino Gaspare Oliva Francesco Paolo Zito Mattia Silvestre Raffaele Bennato Luigi Orsini Raffaella Niola Luigia Romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Interventional Radiology AORN“Antonio Cardarelli”Napoli 80131Italy

BACKGROUND Fistula between the esophagus and bronchial artery is an extremely rare and potentially life-threatening cause of acute upper gastrointestinal ***,we report a case of fistula formation between the esophagus and a nonaneurysmal right bronchial artery(RBA).CASE SUMMARY An 80-year-old woman with previous left pneumonectomy and recent placement of an uncovered self-expandable metallic stent for esophageal adenocarcinoma was admitted due to *** computed tomography showed indirect signs of fistulization between the esophagus and a nonaneurysmal RBA,in the absence of active *** revealed the esophageal stent correctly placed and a moderate amount of red blood within the stomach,in the absence of active bleeding or tumor ingrowth/*** prompt multidisciplinary evaluation,a step-up approach was *** bleeding was successfully controlled by esophageal restenting followed by RBA *** signs of rebleeding were observed and the patient was discharged home with stable hemoglobin level on postoperative day *** This was a previously unreported case of an esophageal RBA fistula successfully managed by esophageal restenting followed by RBA embolization.

关键词： Upper gastrointestinal bleeding Acute upper gastrointestinal bleeding Esophageal fistula Bronchial artery esophageal fistula Esophageal stenting Esophageal self-expandable metal stenting Case report

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The role of computed tomography for the prediction of esophageal variceal bleeding:Current status and future perspectives

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World Journal of Gastrointestinal Endoscopy 2023年第12期15卷 681-689页

作者： Alberto Martino Lucio Amitrano Marianna Guardascione Marco Di Serafino Raffaele Bennato Rossana Martino Annalisa de Leone Luigi Orsini Luigia Romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy

Esophageal variceal bleeding(EVB)is one of the most common and severe complications related to portal hypertension(PH).Despite marked advances in its management during the last three decades,EVB is still associated with significant morbidity and *** risk of first EVB is related to the severity of both PH and liver disease,and to the size and endoscopic appearance of esophageal ***,hepatic venous pressure gradient(HVPG)and esophagogastroduodenoscopy(EGD)are currently recognized as the“gold standard”and the diagnostic reference standard for the prediction of EVB,***,HVPG is an invasive,expensive,and technically complex procedure,not widely available in clinical practice,whereas EGD is mainly limited by its invasive *** this scenario,computed tomography(CT)has been recently proposed as a promising modality for the non-invasive prediction of *** CT is only a diagnostic modality,thus being not capable of supplanting EGD or HVPG in providing therapeutic and physiological data,it could potentially assist liver disease scores,HVPG,and EGD in a more effective prediction of ***,to date,evidence concerning the role of CT in this setting is still *** review aimed to summarize and discuss the current evidence concerning the role of CT in predicting the risk of EVB.

关键词： Esophageal variceal bleeding Variceal upper gastrointestinal bleeding Portal hypertension Computed tomography Computed tomography angiography

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Closure techniques in exposed endoscopic full-thickness resection:Overview and future perspectives in the endoscopic suturing era

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 645-654页

作者： Antonino Granata Alberto Martino Dario Ligresti Francesco Paolo Zito Michele Amata Giovanni Lombardi Mario Traina Digestive Endoscopy Service Department of Diagnostic and Therapeutic ServicesIRCCS–ISMETTPalermo 90127Italy Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy

Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alternative to surgery for the treatment of muscularis propria-originating gastric submucosal *** date,various techniques have been used for the closure of the transmural postEFTR defect,mainly consisting in clip-and endoloop-assisted closure ***,the recent advent of dedicated tools capable of providing full-thickness defect suture could further improve the efficacy and safety of the exposed EFTR *** aim of our review was to evaluate the efficacy and safety of the different closure methods adopted in gastric-exposed EFTR without laparoscopic assistance,also considering the recent advent of flexible endoscopic suturing.

关键词： Endoscopic full-thickness resection Exposed endoscopic full-thickness resection Full-thickness resection Natural orifice transluminal endoscopic surgery Endoscopic surgery Endoscopic suturing

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Prediction of the seismic behavior of an underground railway station and a tunnel in napoli(Italy)

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Underground Space 2017年第2期2卷 88-105页

作者： S.Fabozzi V.Licata S.Autuori E.Bilotta G.Russo F.Silvestri University of napoli Federico II NapoliItaly

The assessment of the seismic safety of underground structures,either tunnels or large station boxes,should not be overlooked especially in densely populated areas,even with low to moderate *** underground structures,an important issue is the estimation of the seismic actions acting on the structure;only few experimental evidences are available for multi-level propped *** tunnels,it is generally assumed that their seismic behavior in soft ground is governed by the surrounding soil,while the inertial load contribution of the underground structure itself is *** both cases,recent numerical studies proved that advanced dynamic analyses can provide satisfactory interpretation of non-linear soil-structure interaction during *** this paper,a real case study,represented by a large open multi-propped excavation and a circular segmented tunnel in a densely urbanized area of the city center in napoli,has been used to investigate some of the mentioned *** geotechnical characterization and choice of the reference input motions lead to a first estimate of the free-field ground motion,which was subsequently used for pseudo-static decoupled *** the complexity of both excavation geometry and staged construction,a full dynamic analysis was considered neither affordable nor reliable for the multi-propped station box;thus two conventional pseudo-static analyses,applying either a displacement-based or a force-based approach,were carried *** the case of the tunnel,the seismic increments of internal forces in the lining could be calculated through both a simplified pseudostatic analysis and a full dynamic analysis,showing a satisfying ***,the results of the study demonstrated that the seismic increments of internal forces in the diaphragm walls of the station and in the segmented lining of the tunnel were quite *** case study encourages improving the reliability of simplified methods based on the more

关键词： Underground structures Tunnels Diaphragm walls Seismic behavior Pseudo-static analysis Dynamic analysis Soil-Structure interaction

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Role of multidetector computed tomography angiography in nonvariceal upper gastrointestinal bleeding:A comprehensive review

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World Journal of Gastrointestinal Endoscopy 2022年第12期14卷 739-747页

作者： Alberto Martino Marco Di Serafino Lucio Amitrano Luigi Orsini Lorena Pietrini Rossana Martino AntonellaMenchise Luca Pignata Luigia Romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy Department of Clinical Medicine and Surgery Gastroenterology and Hepatology UnitUniversity of Naples“Federico II”Napoli 80131Italy

Non-variceal upper gastrointestinal bleeding(NVUGIB)is a common gastroenterological emergency associated with significant morbidity and *** gastrointestinal endoscopy is currently recommended as the gold standard modality for both diagnosis and treatment,with computed tomography traditionally playing a limited role in the diagnosis of acute *** the introduction of multidetector computed tomography(MDCT),this modality is emerging as a promising tool in the diagnosis of ***,to date,evidence concerning the role of MDCT in the NVUGIB diagnosis is still *** aim of our study was to review the current evidence concerning the role of MDCT in the diagnosis of acute NVUGIB.

关键词： Gastrointestinal bleeding Upper gastrointestinal bleeding Non-variceal upper gastrointestinal bleeding Computed tomography Multidetector computed tomography Multidetector computed tomography angiography

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“Tradamixina TP” Compound in Monotherapy for Three Months in Patients with LUTS: Observational Study on Improvement of Urinary Symptoms and Sexual Function in Men

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Health 2019年第6期11卷 621-629页

作者： Trama Francesco Riccardo Filippo Romeo Giuseppe Ruffo Antonio Department of Urology—University Federico II of Naples Via S. Pansini Naples Italy aorn cardarelli napoli Italy

Introduction: Benign Prostatic Hypertrophy (BPH) and Lower Urinary Tract Symptoms (LUTS) frequently affect the male population after the age of 50. Moreover, it is well known that there is a correlation of these symptoms with Erectile Dysfunction (ED) that can reach a frequency of roughly 52% in men aged between 40 and 70 years old. In this study, we aimed at evaluating the effect of a new natural compound “Tradamixina TP” (composed of 80 mg of the algae Ecklonia Bicyclis, 100 mg of Tribulus terrestris and 100 mg of Chitosan Water-soluble oligosaccharide 320 mg of Serenoa repens) in the improvement of Lower Urinary Tract Symptoms (LUTS). Materials & Methods: One-hundred patients with an average age of 64 years old and who were not taking any medication or phytotherapy for prostatic hypertrophy or erectile dysfunction were recruited in the study. All participants were subjected to serum prostate antigen (PSA) and uroflowmetry measuring maximal urine flow/sec (Qmax), at baseline and after 12 weeks. In addition, patients were asked to take the Tradamixina TP for 3 months and to complete at the beginning and end of the treatment the following questionnaires: 1) the IPSS investigating the level of LUTS, and 2) the IIEF-15 investigating the erectile dysfunction. Results: After the treatment, the IPSS scores were lower than those before the treatment. Moreover, a significant effect was found for the IIEF erectile subdomain with scores that were significantly higher at 12 weeks than at baseline. A similar result was found for the IIEF overall subdomain. A decrease of total serum PSA was also observed. Conclusions: After 3 months of daily treatment, the new compound “Tradamixina TP” improved patients’ sexual function, LUTS and led also to a decrease in serum PSA levels.

关键词： Lower Urinary Tract Symptoms Benign Prostatic Hyperplasia Tradamixina TP Erectile Dysfunction Tribulus Terrestris Algae Ecklonia Bicyclis Chitosan Water-Soluble Oligosaccharide

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Conversion therapy for hepatocellular carcinoma to improve treatment strategies for intermediate and advanced stages

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World Journal of Clinical Cases 2024年第28期12卷 6241-6243页

作者： Antonio Giorgio Massimo De Luca Athena Clinic Center Via MatesePiedimonte Matese(CE)81016CampaniaItaly Liver Unit AORN CardarelliVia A.CardarelliNapoli 80131CampaniaItaly

This manuscript is based on a case reported by Song et al published in the World Journal of Clinical *** challenges remain in the field of hepatocellular carcinoma(HCC)conversion ***,only a limited number of patients with HCC accompanied by portal vein tumor thrombosis(PVTT)and hepatic vein tumor thrombosis(HVTT)are eligible for *** clinical case demonstrates that considering the complexity of the disease,a multimodal and multidisciplinary approach is essential for managing HCC accompanied by PVTT and ***,the outcomes of such surgeries remain *** conclusion,research on HCC conversion therapy is extremely useful for impro-ving treatment strategies for intermediate and advanced HCC,which currently have disappointing clinical outcomes.

关键词： Hepatocellular carcinoma Portal vein Inferior vena cava Tumor thrombus Conversion surgery

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Exposed endoscopic full-thickness resection for duodenal submucosal tumors: Current status and future perspectives

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World Journal of Gastrointestinal Endoscopy 2022年第2期14卷 77-84页

作者： Antonino Granata Alberto Martino Francesco Paolo Zito Dario Ligresti Michele Amata Giovanni Lombardi Mario Traina Endoscopy Service Department of Diagnostic and Therapeutic ServicesIRCCS–ISMETTPalermo 90127Italy Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy

Exposed endoscopic full-thickness resection(EFTR),with or without laparoscopic assistance,is an emergent natural orifice transluminal endoscopic surgery technique with promising safety and efficacy for the management of gastrointestinal submucosal tumors(SMTs)arising from the muscularis propria(MP),especially of the gastric *** date,evidence concerning duodenal exposed EFTR is lacking,mainly due to both the technical difficulty involved because of the special duodenal anatomy and concerns about safety and effectiveness of transmural wall defect ***,given the non-negligible morbidity and mortality associated with duodenal surgery,the recent availability of dedicated endoscopic tools for tissue-approximation capable to realize full-thickness defect closure could help in promoting the adoption of this endosurgical technique among referral *** aim of our study was to review the current evidence concerning exposed EFTR with or without laparoscopic assistance for the treatment of MP-arising duodenal SMTs.

关键词： Endoscopic full-thickness resection Exposed endoscopic full-thickness resection Laparoscopy-assisted endoscopic full-thickness resection Duodenal submucosal tumors Novel oral transluminal endoscopic surgery

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