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Botulinum toxin associated with fissurectomy and anoplasty for hypertonic chronic anal fissure: A case-control study

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World Journal of Clinical Cases 2021年第32期9卷 9722-9730页

作者： Beatrice D'Orazio girolamo geraci Fausto Famà gloria Terranova gaetano Di Vita department of Surgical Oncological and Stomatological SciencesUniversity of PalermoPalermo 90100SicilyItaly department of human pathology in adulthood and childhood"g.barresi" University Hospital of MessinaMessina 98121SicilyItaly department of Surgical Oncological and Stomatological SciencesPostgraduate Medical School in General SurgeryUniversity of PalermoPalermo 90100SicilyItaly

BACKgROUND Lateral internal sphincterotomy is still the approach of choice for the treatment of chronic anal fissure(CAF)with internal anal sphincter(IAS)hypertonia,but it is burdened by high-risk postoperative faecal incontinence(FI).Sphincter saving procedures have recently been reconsidered as treatments to overcome this *** most employed procedure is fissurectomy with anoplasty,eventually associated with pharmacological *** To evaluate whether fissurectomy and anoplasty with botulinum toxin injection improves the results of fissurectomy and anoplasty *** We conducted a case-control study involving 30 male patients affected by CAF with hypertonic IAS who underwent fissurectomy and anoplasty with V-Y cutaneous flap *** patients were divided into two groups:Those in group I underwent surgery alone,and those in group II underwent surgery and a botulinum toxin injection directly into the *** were followed up for at least 2 *** goals were to achieve complete healing of the patient and to assess the FI and recurrence rate along with manometry *** The intensity and duration of post-defecatory pain decreased significantly in both groups of patients starting with the first defecation,and this reduction was higher in group *** days after surgery,we achieved complete wound healing in all the patients in group II but only in 80%of the patients in group I(Pgroup,and both healed with conservative *** recorded one temporary and low-grade postoperative case of“de novo”*** parameters reverted to the normal range earlier for group II *** The injection of botulinum toxin A in association with fissurectomy and anoplasty with a V-Y advancement flap improves the results of surgery alone in patients affected by CAF with IAS hypertonia.

关键词： Proctology Fissurectomy Anoplasty Anal fissure Botulinum toxin

Do pathological variables have prognostic significance in rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and surgery?

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World Journal of gastroenterology 2017年第8期23卷 1412-1423页

作者： Luca Reggiani Bonetti Simona Lionti Federica Domati Valeria barresi department of Laboratory Integrated Activities Anatomic Pathology and Legal Medicine Section of Pathology University of Modena and Reggio Emilia department of pathology in Evolutive Age and adulthood "Gaetano Barresi" University of Messina

AIM To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and *** Tumor regression grade(TRg) according to the Dworak system and yT NM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced(c TNM stage Ⅱ and Ⅲ) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival(DFS) and cancer specific survival(CSS) was analyzed by Kaplan Meier and Cox-regression *** cN + status, mucinous histotype or poor differentiation in the pre-treatment biopsy were significantly associated with lower pathological response(low Dworak grade and TNM remaining unchanged/upstaging). Cases showing acellular mucin pools in surgical specimens all had unremarkable clinical courses with no deaths or recurrences during follow-up. Dworak grade had prognostic significance for DFS and CSS. However, compared to the 5-tiered system, a simplified twotiered grading system, in which grades 0, 1 and 2 were grouped as absent/partial regression and grades 3 and 4 were grouped as total/subtotal regression, was more reproducible and prognostically informative. The twotiered Dworak system, yN stage, craniocaudal extension of the tumor and radial margin status were significant independent prognostic variables. CONCLUSION Our data suggest that caution should be applied in using a conservative approach in rectal carcinomas with c N+ status, extensive/lower involvement of the rectum and mucinous histotype or poor differentiation. Although Dworak TRg is prognostically significant, a simplified two-tiered system could be preferable. Finally, cases with acellular mucin pools should be carefully evaluated to definitely exclude residual mucinous carcinoma.

关键词：直肠的癌 Dworak 非细胞组成的粘蛋白水池 Downstaging Mucinous

Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric gastroenterology

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World Journal of gastroenterology 2017年第8期23卷 1328-1337页

作者： Claudio Romano Salvatore Oliva Stefano Martellossi Erasmo Miele Serena Arrigo Maria giovanna graziani Sabrina Cardile Federica gaiani gian Luigi de'Angelis Filippo Torroni Unit of Pediatrics Department of Human Pathology in Adulthood and Childhood“G.Barresi”University of Messina department of Pediatrics and Infantile Neuropsychiatry Pediatric Gastroenterology and Liver UnitSapienza University of Rome Institute for Maternal and Child Health IRCCS‘Burlo garofalo’ department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico II” gastroenterology and Endoscopy Unit G.Gaslini Children’s Hospital-IRCCS gastroenterology and Endoscopy Unit “San Giovanni Addolorata”Hospital Hepatology Gastroenterology and Nutrition UnitBambino GesùChildren’s Hospital gastroenterology and Endoscopy Unit University of Parma department of Surgery and Transplantation Digestive Surgery and Endoscopy UnitBambino GesùChildren’s Hospital

There are many causes of gastrointestinal bleeding(gIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric gIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality. To assist medical care providers in the evaluation and management of children with gIB, the "gastro-Ped Bleed Team" of the Italian Society of Pediatric gastroenterology, Hepatology and Nutrition(SIgENP) carried out a systematic search on MEDLINE via Pub Med(http://***/pubmed/) to identify all articles published in English from January 1990 to 2016; the following key words were used to conduct the electronic search: "upper gIB" and "pediatric" [all fields]; "lower gIB" and "pediatric" [all fields]; "obscure gIB" and "pediatric" [all fields]; "gIB" and "endoscopy" [all fields]; "gIB" and "therapy" [all fields]. The identified publications included articles describing randomized controlled trials, reviews, case reports, cohort studies, casecontrol studies and observational studies. References from the pertinent articles were also reviewed. This paper expresses a position statement of SIgENP that can have an immediate impact on clinical practice and for which sufficient evidence is not available in literature. The experts participating in this effort were selected according to their expertise and professional qualifications.

关键词：胃肠的流血内视镜检查法降低胃肠的流血上面的胃肠的流血小儿科

Endoscopic ultrasound-guided fine-needle aspiration cytology in pancreaticobiliary carcinomas:diagnostic efficacy of cell-block immunocyto-chemistry

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Hepatobiliary & Pancreatic Diseases International 2015年第3期14卷 305-312页

作者： Antonio Ieni Paolo Todaro Stefano Francesco Crinò Valeria barresi giovanni Tuccari department of human pathology "gaetano barresi" Section of Pathological AnatomyAzienda Ospedaliera Universitaria "Policlinico G. Martino" University of Messina department of Internal Medicine Digestive Endoscopy UnitAzienda Ospedaliera Universitaria "Policlinico G. Martino" University of Messina

BACKgROUND： Endoscopic ultrasound-guided fine-needle aspiration cytology was demonstrated to be a useful tool for the diagnosis and staging of pancreaticobiliary neoplastic le- sions. Nonetheless, the diagnostic value of this procedure may be limited by low cellularity of the specimen, contamination of intestinal cells and unfeasibility of ancillary immunocy- tochemical procedures. The present study was to evaluate its usefulness in the diagnosis of neoplastic lesions.

关键词： endoscopic ultrasound fine-needle aspiration cytology pancreas cell-block contaminant cells immunohistochemistry

Usefulness of PET-CT scan in recurrent thyroid cancer

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第3期6卷 182-187页

作者： gianlorenzo Dionigi Fausto Fama Salvatore Antonio Pignata Antonella Pino Alessandro Pontin Ettore Caruso Yantao Fu Shijie Li Carmelo Mazzeo Hui Sun Sergio Baldari Division for Endocrine and Minimally Invasive Surgery Department of Human Pathology in Adulthood and Childhood"G.Borresi"University Hospital G.MartinoUniversity of MessinaMessinaItaly Nuclear Medicine Unit Department of Biomedical and Dental Sciences and Morpho-Functional ImagingUniversity Hospital G.MartinoUniversity of MessinaMessinaItaly Jilin Provincial Key Laboratory of Surgical Translational Medicine Division of Thyroid SurgeryChina-Japan Union Hospital of Jilin UniversityChangchunJilin ProvinceChina Division for Emergency Surgery Department of Human Pathology in Adulthood and Childhood"G.BarresiffUniversity Hospital G.MartinoUniversity of MessinaMessinaItaly

The aim of this paper is to discuss the risk of recurrence in patients with differentiated thyroid cancer and emphasize the importance of risk-group stratification,early recurrence identification and application of new imaging modalities,what is the ***,follow-up of patients with thyroid carcinoma should be carried out by specialized teams throughout ***,interdisciplinary case discussions in tumor conferences may improve the use of multimodal therapy especially in patients with poorly differentiated thyroid *** baseline follow-up,if there is a suspicion of thyroid carcinoma,early PET-CT should be used for early detection and appropriate ***,due to the good localization possibility,the PET-CT enables a focused surgical procedure with avoidance of an unnecessary tumor search and thereby a reduction of the risk of injury of neighboring structures which is a concern with reoperative neck surgery.

关键词： Thyroid Thyroidectomy PET-CT Thyroid cancer Recurrence

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

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World Journal of Clinical Cases 2018年第10期6卷 384-392页

作者： Francesco Fleres Antonio Ieni Edoardo Saladino giuseppe Speciale Michele Aspromonte Antonio Cannaò Antonio Macrì department of human pathology of the Adult and Evolutive Age "gaetano barresi" Section of General Surgery University of Messina department of human pathology of the Adult and Evolutive Age "gaetano barresi" Section of Anatomic Pathology University of Messina general and Oncologic Surgery Unit Clinica Cappellani-GIOMI Messina University Medical School Hospital Peritoneal Surface Malignancy and Soft Tissue Sarcoma Program Messina University Medical School Hospital

The accidental ingestion of a foreign body(FB) is a relatively common condition. In the present study, we report a peculiar case of rectal perforation, the first to our knowledge, caused by the inadvertent ingestion of a blister pill pack. The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation. A 75-year-old woman, mentally impaired, arrived at our emergency department in critical condition. The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air. The patient was therefore submitted to an urgent exploratory laparotomy; a 2-cm long, full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum. Hence, we performed a Hartmann's procedure. Because of her critical condition, the patient was eventually transferred to the Intensive Care Unit, where she died after 10 d, showing no surgical complication. The ingestion of FBs is usually treated with observation or endoscopic removal. Less than 1% of FBs are likely to cause an intestinal perforation. The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment, due to its late diagnosis and the patients' deteriorated clinical condition.

关键词： Foreign body Acute abdomen syndrome Ingestion Rectal perforation Blister pill pack

对《不孕妇女的功能障碍、精神病症状和生活质量:一项来自土耳其横断面研究》一文的述评（英文）

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上海精神医学 2016年第6期28卷 353-354页

作者： Vitale Sg La Rosa VL Rapisarda AMC Laganà AS Unit of gynecology and Obstetrics Department of Human Pathology in Adulthood and Childhood "G. Barresi"University of Messina Unit of Psychodiagnostics and Clinical Psychology University of Catania department of general Surgery and Medical Surgical Specialties University of Catania

概述:本文旨在对在本刊刊登的有关土耳其不孕症妇女的功能障碍、精神症状和生活质量的研究发表一些见解。我们提议将来的研究应使用较大的样本,同时要考虑诸如导致不孕症的病因以及辅助生育技术(ARTs)等影响因素,最后也是很重要的一点,... 详细信息

概述:本文旨在对在本刊刊登的有关土耳其不孕症妇女的功能障碍、精神症状和生活质量的研究发表一些见解。我们提议将来的研究应使用较大的样本,同时要考虑诸如导致不孕症的病因以及辅助生育技术(ARTs)等影响因素,最后也是很重要的一点,就是要排除可能影响数据分析的其他共病情况。

关键词：不孕症功能障碍生活质量

Changes in human epidermal growth factor receptor 2 status between primary breast/gastric carcinomas and synchronous metastatic lymph nodes: how can we explain them?

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Journal of Cancer Metastasis and Treatment 2015年第1期1卷 21-26页

作者： Antonio Ieni Valeria barresi giovanni Branca Luana Licata Rosario Alberto Caruso giovanni Tuccari department of human pathology“gaetano barresi” University of Messina98125 MessinaItaly.

Aim:Previous studies demonstrated discordant expression of human epidermal growth-factor receptor 2(HER2)between primary cancer and their recurrence/*** study further evaluated HER2 status between primary gastric and breast invasive carcinomas and paired metastatic disease to lymph ***:This study collected formalin-fi xed paraffi n-embedded representative tissue blocks from 62 gastric and 65 breast primary carcinomas as well as synchronous metastatic lymph nodes(male:female=39:88;age ranged between 44 and 95 years with mean age of 69.32 years)for immunohistochemical staining of HER2 expression(DAKO HercepTest^(TM)kit).If immunohistochemical HER2 score reached to 2+,HER2 amplifi cation was then assessed using fl uorescence in situ hybridization(PharmDx^(TM)kit DAKO).Results:The discordant HER2 pooled rate,regardless either negative or positive conversion,was 9.67%in primary gastric carcinoma and corresponding nodal metastasis,while the changes in HER2 expression were revealed in 4.61%of mammary and lymph node neoplastic samples.A high-level concordance in HER2 expression between primary carcinoma and synchronous metastatic lymph nodes was confi rmed in both types of cancer;the observed event of discordant HER2 status should be ascribed to intra-tumor heterogeneity,mostly appreciable in gastric ***:In any case,the shift from positive to negative HER2 expression suggests that trastuzumab could be the targeted treatment choice whereas the opposite shift should be evaluated by a simultaneous HER2 determination in both primary and metastatic lymph nodes.

关键词： Breast cancer epidermal growth-factor receptor 2 gastric cancer lymph node metastasis

Role of urocortin in pregnancy: An update and future perspectives

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World Journal of Clinical Cases 2016年第7期4卷 165-171页

作者： Salvatore giovanni Vitale Antonio Simone Laganà Agnese Maria Chiara Rapisarda Maria giovanna Scarale Francesco Corrado Pietro Cignini Salvatore Butticè Diego Rossetti Unit of gynecology and Obstetrics Department of Human Pathology in Adulthood and Childhood "G. Barresi" University of Messina department of general Surgery and Medical Surgical Specialties University of Catania department of Clinical and Com-munity Sciences University of Milan department of Prenatal Diagnosis Altamedica Fetal Maternal Medical Center Unit of Urology Department of Human Pathology University of Messina department of Maternal and Child Health Gavardo Hospital

The activities of corticotropin-releasing factor(CRF) and related peptides are mediated a number of receptors with seven transmembrane domains that are coupled to the gs and gq proteins. These receptors are known as CRF-Rs. In vitro studies have evidenced that urocortin(UCN) and CRF provoke an increase in the contractility of the uterus which is induced by endometrial prostaglandin F2 a. Furthermore, through trophoblasts, it stimulates the secretion of adrenocorticotropic hormone(ACTH) and prostaglandin PgE2 and has a vasodilatory effect on the placenta. While it is well known that the placenta produces considerable quantities of CRF, several studies have, however, excluded that the placenta can generate significant quantities of UCN. In the short term, the human fetal adrenal gland produces more cortisol and dehydroepiandrosterone sulfate. The gestational tissues express UCN3 and UCN2 m RNA in cytotrophoblast and syncytiotrophoblast cells, while UCN2 is only to be found in the maternal and fetal vessels and amniotic cells. Nevertheless, gestational tissues express UCN2 and UCN3 differentially and do not stimulate placental ACTH secretion. In term pregnancies, maternal plasma levels of CRF and UCN are lower than at the beginning of pregnancy and are correlated to labor onset. Conversely,they do not decrease in post-term pregnancies. This evidence would seem to indicate that the fine-regulated expression of these neuropeptides is important in determining the duration of human gestation. In this scenario, low concentrations of UCN in the amniotic fluid at mid-term may be considered a sign of predisposition to preterm birth.

关键词： Urocortin Corticotropin-releasing factor Obstetrics gynecology Inflammation