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CEUS and Fibroscan in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis

World Journal of Hepatology 2014年第7期6卷 496-503页

作者： Sila Cocciolillo Giustino Parruti Leonardo Marzio digestive physiopathology unit Gabriele d’Annunzio University Pescara Civic Hospital 65124 Pescara Italy Infectious and Tropical Diseases unit Pescara Civic Hospital 65124 Pescara Italy

AIM: To determine intra-hepatic blood flow and liver stiffness in patients with non-alcoholic fatty liver disease(NAFLD) and non-alcoholic steatohepatitis (NASH) using contrast-enhanced ultrasound and ***: This prospective study included 15 patients with NAFLD, 17 patients with NASH and 16 healthy *** each patient, real-time ultrasound was used to locate the portal vein (PV) and the right liver lobe, and 5 mL of SonoVue? was then injected intravenous in a peripheral vein of the left arm over a 4-s span. Digital recording was performed for 3 min thereafter. The recording was subsequently retrieved to identify an area of interest in the PV area and in the right liver parenchyma(LP) to assess the blood flow by processing the data using dedicated software (Qontrast?, Bracco, Italy).The following parameters were evaluated: percentage of maximal contrast activity (Peak%), time to peak (TTP, s), regional blood volume (RBV, cm3), regional blood flow (RBF, cm3/s) and mean transit time (MTT, s).At 24-48 h post-injection, liver stiffness was evaluated using Fibroscan and measured in kPa. The statistical evaluation was performed using Student’s t ***: In the PV, the Peak%, RBV and RBF were significantly reduced in the NAFLD and NASH patientscompared with the controls (Peak%: NAFLD 26.3 ± 6.6,NASH 28.1 ± 7.3 vs controls 55.8 ± 9.9, P < 0.001;RBV: NAFLD 4202.3 ± 3519.7, NASH 3929.8 ± 1941.3vs controls 7473 ± 3281, P < 0.01; RBF: NAFLD 32.5± 10.8, NASH 32.7 ± 12.1 vs controls 73.1 ± 13.9, P< 0.001). The TTP in the PV was longer in both patient groups but reached statistical significance only in the NASH patients compared with the controls (NASH 79.5± 37.8 vs controls 43.2 ± 30, P < 0.01). In the LP,the Peak%, RBV and RBF were significantly reduced in the NAFLD and NASH patients compared with the controls (Peak%: NAFLD 43.2 ± 7.3, NASH 41.7 ± 7.7 vs controls 56.6 ± 6.3, P < 0.001; RBV: NAFLD 4851.5± 2009, NASH 5069.4 ± 2292.5 vs controls 6922.9 ±2461.

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Contrast-enhanced ultrasound Fibroscan Hepatic blood flow Liver stiffness

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Quadruple therapy with moxifloxacin and bismuth for first-line treatment ofHelicobacter pylori

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World Journal of Gastroenterology 2012年第32期18卷 4386-4390页

作者： Antonio Francesco Ciccaglione Luigina Cellini Laurino Grossi Leonardo Marzio digestive physiopathology unit Gabriele d'Annunzio UniversityPescara Civic Hospital65124 PescaraItaly Department of Drug Sciences Gabriele d'Annunzio University66013 ChietiItaly

AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment ofHelicobacter pylori(***) ***:Consecutive *** positive patients never treated in the past for this infection were randomly treated with triple therapy of pantoprazole(PAN) 20 mg bid,amoxicillin(AMO) 1 g bid and moxifloxacin(MOX) 400 mg bid for 10 d(PAM) or with quadruple therapy of PAN 20 mg bid,AMO 1 g bid,MOX 400 mg bid and bismuth subcitrate 240 mg bid for 10 d(PAMB).All patients were found positive at 13 C-Urea breath test(UBT) performed within ten days prior to the start of the study.A successful outcome was confirmed with an UBT performed 8 wk after the end of treatment.χ 2 analysis was used for statistical *** protocol(PP) and intention-to-treat(ITT) values were also ***:Fifty-seven patients were enrolled in the PAM group and 50 in the PAMB *** patient in each group did not return for further *** was higher in the PAMB group(negative:46 and positive:3) vs the PAM group(negative:44 and positive:12).The *** eradication rate was statistically significantly higher in the PAMB group vs the PAM group,both with the PP and ITT analyses(PP:PAMB 93.8%,PAM 78.5%,P < 0.02;ITT:PAMB 92%,PAM 77.1 %,P <0.03).CONCLUSION:The addition of bismuth subcitrate can be considered a valuable adjuvant to triple therapy in those areas where *** shows a high resistance to fluoroquinolones.

关键词： Helicobacter pylori infection First-line therapy Quadruple therapy Amoxicillin Moxifloxacin Bismuth subcitrate

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New therapeutic strategy with extracorporeal membrane oxygenation for refractory hepatopulmonary syndrome after liver transplant: A case report

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World Journal of Transplantation 2024年第1期14卷 210-214页

作者： Belinda Sánchez Pérez María Pérez Reyes Jose Aranda Narvaez Julio Santoyo Villalba Jose Antonio Perez Daga Claudia Sanchez-Gonzalez Julio Santoyo-Santoyo Hepatobiliary and Trasplantation unit General and Digestive Surgery DepartmentUniversity Regional HospitalMalaga 29010Spain Department of General and digestive Surgery Regional University Hospital of MalagaMalaga 29010Spain

BACKGROUND Due to the lack of published literature about treatment of refractory hepatopulmonary syndrome(HPS)after liver transplant(LT),this case adds information and experience on this issue along with a treatment with positive *** is a complication of end-stage liver disease,with a 10%-30%incidence in cirrhotic *** can reverse the physiopathology of this process and restore normal ***,in some cases,refractory hypoxemia persists,and extracorporeal membrane oxygenation(ECMO)can be used as a rescue therapy with good *** SUMMARY A 59-year-old patient with alcohol-related liver cirrhosis and portal hypertension was included in the LT waiting list for *** had good liver function(Model for End-Stage Liver Disease score 12,Child-Pugh class B7).He had pulmonary fibrosis and a mild restrictive respiratory pattern with a basal oxygen saturation of 82%.The macroaggregated albumin test result was>*** demonstrated a forced expiratory volume in one second(FEV1)of 78%,forced vital capacity(FVC)of 74%,FEV1/FVC ratio of 81%,diffusion capacity for carbon monoxide of 42%,and carbon monoxide transfer coefficient of 57%.He required domiciliary oxygen at 2 L/min(16 h/d).The patient was admitted to the intensive care unit(ICU)and extubated in the first 24 h,needing high-flow therapy and non-invasive ventilation and inhaled nitric oxide *** was needed after 72 *** to the non-response to supportive therapies,installation of ECMO was decided with progressive recovery after 9 *** was possible on the tenth day,maintaining a high-flow nasal cannula and de-escalating to conventional oxygen therapy after 48 *** was discharged from ICU on postoperative day(POD)20 with a 90%-92%oxygen *** recycling was needed twice for acute *** patient was discharged from hospital on POD 27 with no symptoms,with an 89%-90%oxygen *** Due to the favorable results observed,ECMO could bec

关键词： Liver transplantation Hepatopulmonary syndrome Refractory hypoxemia Treatment Extracorporeal membrane oxygenation Case report

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The duration of the conventional chemoembolization for hepatocellular carcinoma:factors affecting the procedural time

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Hepatoma Research 2022年第1期8卷 313-326页

作者： Matteo Renzulli Mattia Gentilini Giovanni Marasco Nicolo Brandi Alessandro Granito Silvia Lo Monaco Anna Maria Ierardi Antonio De Cinque Francesco Tovoli Laura Bartalena Daniele Spinelli Fabio Piscaglia Rita Golfieri Department of Radiology IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Internal Medicine and digestive physiopathology unit IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Division of Internal Medicine IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Diagnostic and Interventional Radiology Department Fondazione IRCCS CàGranda Ospedale Maggiore PoliclinicoUniversitàdegli Studi di Milano MilanMilan 20122Italy

Aim:The present study evaluated the duration of chemoembolization in patients with hepatocellular carcinoma,analyzing possible factors affecting the procedural ***:In total,175 patients who underwent chemoembolization have been prospectively *** procedural length was considered the time between the insertion and the removal of the angiographic *** features related to the tumor burden and angiographic procedures,which could be related to the procedural time,were ***:The chemoembolization time resulted in a mean of 58.1 *** longer procedural time was associated with a number of nodules treated per patient≥2(P<0.001),a number of segments with nodules≥2(P<0.001),the presence of more than 1 nodule in the same segment(P<0.001),the location of the tumor in the left lobe(P=0.001),the exclusion from the Milan criteria(P<0.001),and a number of segments treated≥2(P<0.001).Only the number of nodules treated per patient resulted significantly in multivariate analysis(OR 2.927,95%CI:2.015-4.251,P<0.001).Conclusion:The factors related to longer procedural time are the number of nodules treated≥2,the number of segments with nodules≥2,the involvement of the left lobe,the tumor burden outside the Milan criteria,and the number of segments treated≥*** these characteristics,known in the pre-procedural phase,represent useful tools for a correct planning of the angiographic room’s workflow during the pandemic era as well as in the future to reduce downtime and increase productivity.

关键词： Chemoembolization hepatocellular carcinoma procedural time angiographic room management

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Dual regulatory role for phosphatase and tensin homolog in specification of intestinal endocrine cell subtypes

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World Journal of Gastroenterology 2012年第14期18卷 1579-1589页

作者： Sébastien AB Roy Marie-Josée Langlois Julie C Carrier Franois Boudreau Nathalie Rivard Nathalie Perreault Canadian Institutes of Health Research Team on digestive Epithelium Department of Anatomy and Cell BiologyFaculty of Medicine and Health SciencesUniversité de SherbrookeSherbrooke J1H 5N4QCCanada Canadian Institutes of Health Research Team on digestive Epithelium Service of GastroenterologyFaculty of Medicine and Health SciencesUniversité de SherbrookeSherbrooke J1H 5N4QCCanada

AIM:To investigate the impact of phosphatase and tensin homolog(Pten) in the specification of intestinal enteroendocrine ***:Using the Cre/loxP system,a mouse with conditional intestinal epithelial Pten deficiency was *** mutant mice and controls were sacrificed and small intestines collected for immunofluorescence and quantitative real-time polymerase chain *** was collected on 16 h fasted mice by cardiac ***-linked immunosorbent assay was used to measure blood circulating ghrelin,somatostatin(SST) and glucose-dependent insulinotropic peptide(GIP) ***:Results show an unexpected dual regulatory role for epithelial Pten signalling in the specification/differentiation of enteroendocrine cell subpopulations in the small *** data indicate that Pten positively regulates chromogranin A(CgA) expressing subpopulations,including cells expressing secretin,ghrelin,gastrin and cholecystokinin(CCK).In contrast,Pten negatively regulates the enteroendocrine subtype specification of non-expressing CgA cells such as GIP and SST expressing ***:The present results demonstrate that Pten signalling favours the enteroendocrine progenitor to specify into cells expressing CgA including those producing CCK,gastrin and ghrelin.

关键词： Phosphatase and tensin homolog Enteroendocrine cells Intestinal epithelial cell specification Chromogranin A

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COX-2 in liver,from regeneration to hepatocarcinogenesis:What we have learned from animal models?

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World Journal of Gastroenterology 2010年第12期16卷 1430-1435页

作者： Paloma Martín-Sanz Rafael Mayoral Marta Casado Lisardo Boscá Biomedical Network Center for the Study of Hepatic and digestive Diseases(CIBERehd) Department of Metabolism and Cell Signaling Institute of Biomedical Research "Alberto Sols"(CSIC-UAM) Department of Pathology and Molecular and Cellular Therapy Institute of Biomedicine of Valencia(IBV-CSIC)

The use of animals lacking genes or expressing genes under the control of cell-specific promoters has signifi cantly increased our knowledge of the genetic and molecular basis of physiopathology,allowing testing of functional hypotheses and validation of biochemical and pharmacologic approaches in order to understand cell ***,with unexpected frequency,gene knockout animals and,more commonly,animal models of transgenesis give experimental support to even opposite conclusions on gene *** we summarize what we learned on the role of cyclooxygenase 2(COX-2) in liver and revise the results obtained in 3 independent models of mice expressing a COX-2 transgene specifi cally in the *** challenge with pro-inflammatory stimuli,the animals behave very differently,some transgenic models having a protective effect but others enhancing the *** addition,one transgene exerts differential effects on normal liver physiology depending on the transgenic animal model used.

关键词： Cyclooxygenase 2 Prostaglandins Liver diseases Apoptosis Inflammation Animal models

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Hyperammonemia induced oxidative stress in cirrhotic rats without promoting differential protein expression in the brain cortex: A 2D-DIGE analysis

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Advances in Bioscience and Biotechnology 2012年第8期3卷 1116-1123页

作者： Pilar Carbonero-Aguilar Ma del Mar Diaz-Herrero José A. del Campo Olga Cremades Manuel Romero-Gómez Juan Bautista Departamento de Bioquímica y Biología Molecular Facultad de Farmacia Universidad de Sevilla Sevilla Spain UCM digestive Diseases and CIBERehd Hospital Universitario de Valme Sevilla Spain

Oxidative stress induced by a high ammonia concentration could modify protein expression in the brain. This study was undertaken in order to investigate the impact of hyperammonemia, caused by thioacetmide (TAA) in rats, on brain cortex protein expression using 2D-DIGE, and analyzing its role in the pathogenesis of HE. Hyperammonemia was induced with TAA. Ammonia and active oxidants were measured by L-glutamate dehydrogenase and dichlorodihydrofluorescein diacetate methods, respectively. Lipid peroxidation and protein oxidation biomarkers were also studied. Differential protein expression in the cortex of TAA- and control-rats was studied by 2D-DIGE. Image analysis was performed using the DeCyder? Software. Ammonia concentration in plasma and brain tissue was higher in TAA-rats compared to control-rats, 3.12 and 2.43 fold higher, respectively. Active oxidants production in TAA-rats was increased by 2.7 fold compared to control-rats. Measurements of MDA, HNE and carbonyl groups, biomarkers of lipid peroxidation and protein oxidation respectively, were found to be statistically significantly increased in TAA-rats compared to control-rats (3.16-, 2.44- and 1.95-fold, respectively), reflecting the presence of oxidative stress in the brain of TAA-rats. 2D-DIGE analysis of brain cortex protein allowed the detection of 2896 spots, however, image analysis showed no statistically significant differential protein expression between the proteins expressed in TAA- and control-rats. No statistical significant differential protein expression in the cortex of TAA-rats was observed, although oxidative stress biomarkers for lipid and proteins were higher in the brain of TAA-rats than in control-rats. These results support the idea that oxidative post-translational modifications are implicated in HE physiopathology.

关键词： Oxidative Stress Hyperammonemia Cirrhosis Hepatic Encephalopathy Protein Expression

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