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Dysregulation of genes involved in the long-chain fatty acid transport in pancreatic ductal adenocarcinoma

World Journal of Gastrointestinal Oncology 2025年第1期17卷 199-206页

作者： Radu Cristian Poenaru Elena Milanesi Andrei Marian Niculae Anastasia-Maria Dobre Catalina Vladut Mihai Ciocîrlan Daniel Vasile Balaban Vlad Herlea Maria Dobre Mihail Eugen Hinescu Faculty of Medicine Carol Davila University of Medicine and PharmacyBucharest 050474Romania Department of Radiobiology Victor Babes National Institute of PathologyBucharest 050096Romania Department of Pathology Victor Babes National Institute of PathologyBucharest 050096Romania Department of Gastroenterology Prof.Dr.Agrippa Ionescu Clinical Emergency HospitalBucharest 011356Romania Department of Pathology Fundeni Clinical InstituteBucharest 022258Romania

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is an aggressive lethal malignancy with limited options for treatment and a 5-year survival rate of 11%in the United *** for other types of tumors,such as colorectal cancer,aberrant de novo lipid synthesis and reprogrammed lipid metabolism have been suggested to be associated with PDAC development and *** To identify the possible involvement of lipid metabolism in PDAC by analyzing in tumoral and non-tumoral tissues the expression level of the most relevant genes involved in the long-chain fatty acid(FA)import into *** A gene expression analysis of FASN,CD36,SLC27A1,SLC27A2,SLC27A3,SLC27A4,SLC27A5,ACSL1,and ACSL3 was performed by qRT-PCR in 24 tumoral PDAC tissues and 11 samples from non-tumoral pancreatic tissues obtained via fine needle aspiration or via surgical *** genes were considered significantly dysregulated between the groups when the p value was<0.05 and the fold change(FC)was≤0.5 and≥*** We found that three FA transporters and two long-chain acyl-CoA synthetases genes were significantly upregulated in the PDAC tissue compared to the non-tumoral tissue:SLC27A2(FC=5.66;P=0.033),SLC27A3(FC=2.68;P=0.040),SLC27A4(FC=3.13;P=0.033),ACSL1(FC=4.10;P<0.001),and ACSL3(FC=2.67;P=0.012).We further investigated any possible association between the levels of the analyzed mRNAs and the specific characteristics of the tumors,including the anatomic location,the lymph node involvement,and the presence of metastasis.A significant difference in the expression of SLC27A3(FC=3.28;P=0.040)was found comparing patients with and without lymph nodes involvement with an overexpression of this transcript in 17 patients presenting tumoral cells in the lymph *** Despite the low number of patients analyzed,these preliminary results seem to be *** lipid metabolism through a broad strategy could be a beneficial way to treat this *** in vitro and in vivo s

关键词： Carcinoma Pancreatic ductal Fatty acid transport Gene expression Biomarkers

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Neurological complications of hematopoietic cell transplantation in children and adults

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Neural Regeneration Research 2018年第6期13卷 945-954页

作者： Adriana Octaviana Dulamea Ioana Gabriela Lupescu University of Medicine and Pharmacy Carol Davila Bucharest Romania Department of Neurology Fundeni Clinical Institute Bucharest Romania Radiology and Medical imaging Department Fundeni Clinical Institute Bucharest Romania

Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched donor（allogeneic） or from the patient（autologous）. Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease（Gv HD）. Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, Gv HD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT：（1） early complications（in the first month）-related to harvesting of stem cells, during conditioning（drug toxicity, posterior reversible encephalopathy syndrome）, related to pancytopenia,（2） intermediate phase complications（second to sixth month）-central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus,（3） late phase complications（after sixth month）-neurological complications of Gv HD, second neoplasms and relapses of the original disease.

关键词： neurological complications hematopoietic cell transplantation posterior reversible encephalopathy syndrome central nervous system infections progressive multifocal leukoencephalopathy graft versus host disease second neoplasm immune reconstitution inflammatory syndrome post-transplant acute limbic encephalitis drug reaction with eosinophiIia and systemic symptoms

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Aggressive surgical approach in patients with adrenal-only metastases from hepatocellular carcinoma enables higher survival rates than standard systemic therapy

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 28-33页

作者： Sorin T Alexandrescu Adina E Croitoru Razvan T Grigorie Dana R Tomescu Gabriela Droc Mugur C Grasu Irinel Popescu Dan Setlacec Centre of General Surgery and Liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania Carol Davila University of Medicine and Pharmacy Bucharest 020021Romania Department of Oncology Fundeni Clinical InstituteBucharest 022328Romania Faculty of Medicine Titu Maiorescu UniversityBucharest 031593Romania Dan Tulbure Centre of Anesteziology and Intensive Care Fundeni Clinical InstituteBucharest 022328Romania Department of Radiology Fundeni Clinical InstituteBucharest 022328Romania

Background:Although guidelines recommend systemic therapy even in patients with limited extrahepatic metastases from hepatocellular carcinoma(HCC),a few recent studies suggested a potential benefit for resection of extrahepatic ***,the benefit of adrenal resection(AR)for adrenal-only metastases(AOM)from HCC was not proved *** is the first study to compare long-term outcomes of AR to those of sorafenib in patients with AOM from ***:The patients with adrenal metastases(AM)from HCC were identified from the electronic records of the institution between January 2002 and December *** who presented AM and other sites of extrahepatic disease were ***,the patients with AOM who received other therapies than AR or sorafenib were ***:A total of 34 patients with AM from HCC were *** of these,22 patients had AOM,6 receiving other treatment than AR or ***,8 patients with AOM underwent AR(AR group),while 8 patients were treated with sorafenib(SOR group).The baseline characteristics of the two groups were not significantly different in terms of age,sex,number and size of the primary tumor,timing of AM diagnosis,Child-Pugh and ECOG *** a median follow-up of 15.5 months,in the AR group,the 1-,3-,and 5-year overall survival rates(85.7%,42.9%,and 0%,respectively)were significantly higher than those achieved in the SOR group(62.5%,0%and 0%at 1-,3-and 5-year,respectively)(P=0.009).The median progression-free survival after AR(14 months)was significantly longer than that after sorafenib therapy(6 months,P=0.002).Conclusions:In patients with AOM from HCC,AR was associated with significantly higher overall and progression-free survival rates than systemic therapy with *** results could represent a starting-point for future phase II/III clinical trials.

关键词： Adrenal metastases Hepatocellular carcinoma Adrenal resection Sorafenib Survival

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The contribution of oligodendrocytes and oligodendrocyte progenitor cells to central nervous system repair in multiple sclerosis： perspectives for remyelination therapeutic strategies

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Neural Regeneration Research 2017年第12期12卷 1939-1944页

作者： Adriana Octaviana Dulamea Department of Neurology Fundeni Clinical Institute University of Medicine and Pharmacy "Carol Davila" Bucharest Romania

Oligodencrocytes（OLs） are the main glial cells of the central nervous system involved in myelination of axons. In multiple sclerosis（MS）, there is an imbalance between demyelination and remyelination processes, the last one performed by oligodendrocyte progenitor cells（OPCs） and OLs, resulting into a permanent demyelination, axonal damage and neuronal loss. In MS lesions, astrocytes and microglias play an important part in permeabilization of blood-brain barrier and initiation of OPCs proliferation. Migration and differentiation of OPCs are influenced by various factors and the process is finalized by insufficient acummulation of OLs into the MS lesion. In relation to all these processes, the author will discuss the potential targets for remyelination strategies.

关键词： multiple sclerosis oligodencrocytes oligodendrocyte progenitor cells demyelination remyelination semaphorin basic helix-loop-helix transcription factor oligodendrocyte transcription factor 2 leucin-rich repeatand immunoglobulin-like-domain-containing nogo receptor-interacting protein I canonical Notch signaling endocrine receptors

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Male gender and increased body mass index independently predicts clinically relevant morbidity after spleen-preserving distal pancreatectomy

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World Journal of Gastrointestinal Surgery 2018年第8期10卷 84-89页

作者： Traian Dumitrascu Mihai Eftimie ANDra Aiordachioae Cezar Stroescu Simona Dima Mihnea Ionescu Irinel Popescu Department of General Surgery and Liver Transplant Fundeni Clinical Institute

AIM To identify risk factors for clinically relevant complications after spleen-preserving distal pancreatectomy(SPDP). No previous studies explored potential predictors of morbidity after *** The data of 41 patients who underwent a SPDP in a single surgical center between 2000 and 2015 were retrospectively reviewed from a prospectively maintained electronic database established in our Department of Surgery. The database included demographic, clinical, bioumoral, pathological, intraoperative and postoperative parameters. Uni-and multivariate ana-lyses were performed to assess potential predictors of clinically relevant morbidity. Postoperative morbidity was defined as in-hospital complications and mortality was assessed at 90 d. clinically relevant morbidity was defined as complication ≥ grade 2 *** Overall morbidity rate was 34.1%(14 patients): grade Ⅰ(6 patients, 14.6%), grade Ⅱ(2 patients, 4.8%), grade Ⅲa(1 patient, 2.4%), and grade Ⅲb(5 patients, 12.2%). A number of 5 patients(12.2%) required re-laparotomy for postoperative complications. There was no postoperative mortality. Thus, at least one clinically relevant complication occurred in 8 patients(19.5%). Univariate analysis identified male gender(P = 0.034), increased body mass index(P = 0.002) and neuroendocrine pathology(P = 0.013) as statistically significant risk factors. Multivariate analysis identified male gender [odds ratio(OR): 1.29, 95%CI: 1.07-1.55, P = 0.005] and increased body mass index(OR: 23.18, 95%CI: 1.72-310.96, P = 0.018) as the only independent risk factors of clinically relevant morbidity after *** Male gender and increased body mass index are independently associated with increased risk of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.

关键词： Spleen-preserving distal pancreatectomy Morbidity Male gender Body mass index

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Robot-assisted surgery for gastric cancer

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World Journal of Gastrointestinal Oncology 2016年第1期8卷 8-17页

作者： livia procopiuc stefan tudor mircea manuc mircea diculescu catalin vasilescu "carol davila"university of medicine and pharmacy 020022 BucharestRomania department of general surgery and liver transplantation fundeni clinical institute022238 BucharestRomania department of gastroen-terology and hepatology fundeni clinical institute022238 BucharestRomania

Minimally invasive surgery for gastric cancer is a rela-tively new research field, with convincing results mostly stemming from Asian countries. The use of the robotic surgery platform, thus far assessed as a safe procedure, which is also easier to learn, sets the background for a wider spread of minimally invasive technique in the treatment of gastric cancer. This review will cover the literature published so far, analyzing the pros and cons of robotic surgery and highlighting the remaining study questions.

关键词： Gastric cancer survival Robotic surgery Gastric cancer surgery Lymphadenectomy Minimallyinvasive surgery

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High perioperative lactate levels and decreased lactate clearance are associated with increased incidence of posthepatectomy liver failure

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Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 592-594页

作者： Mihai Popescu Simona Dima Vladislav Brasoveanu Andrada Tudor Mihai Simionescu Dana Tomescu “Carol Davila”University of Medicine and Pharmacy Bucharest 020021Romania Department of Anesthesia and Intensive Care Fundeni Clinical InstituteBucharest 022328Romania “Dan Setlacec”Center for General Surgery and Liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania

To the Editor:Extensive liver resection represents a life-saving intervention in patients with primary or secondary liver *** advances made in the field of chemotherapy and surgical techniques have translated into a greater number of patients who are older and with more complex comorbidities presenting for major liver surgery[1]and thus having an increased risk of perioperative mortality.

关键词： chemotherapy liver mortality

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Endoscopic ultrasound-guided fine-needle aspiration pancreatic adenocarcinoma samples yield adequate DNA for next-generation sequencing:A cohort analysis

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World Journal of Gastroenterology 2023年第18期29卷 2864-2874页

作者： Stefania Bunduc Bianca Varzaru Razvan Andrei Iacob Andrei Sorop Ioana Manea Andreea Spiridon Raluca Chelaru Adina Emilia Croitoru Gabriel Becheanu Mona Dumbrava Simona Dima Irinel Popescu Cristian Gheorghe Faculty of Medicine Carol Davila University of Medicine and PharmacyBucharest 020021Romania Digestive Diseases and Liver Transplantation Center Fundeni Clinical InstituteBucharest 022328Romania Center of Excellence in Translational Medicine Fundeni Clinical InstituteBucharest 022328Romania

BACKGROUND Genetic tests are increasingly performed for the management of unresectable pancreatic *** genotyping aimed samples current guidelines recommend using core specimens,although based on moderate quality ***,in clinical practice among the endoscopic ultrasound(EUS) guided tissue acquisition methods,fine needle aspiration(FNA) is the most widely *** To assess the adequacy for next generation sequencing(NGS) of the DNA yielded from EUS-FNA pancreatic adenocarcinoma(PDAC) *** Between November 2018 and December 2021,105 patients with PDAC confirmed by EUS-FNA were included in the study at our tertiary gastroenterology *** 22 gauge(G) or 19G FNA needles were *** pass was dedicated to DNA *** concentration and purity(A260/280,A260/230) were assessed by *** assessed the differences in DNA parameters according to needle size and tumor characteristics(size,location) and the adequacy of the extracted DNA for NGS(defined as A260/280 ≥ 1.7,and DNA yield:≥ 10 ng for amplicon based NGS,≥ 50 ng for whole exome sequencing [WES],≥ 100 ng for whole genome sequencing [WGS]) by analysis of variance and ttest ***,we compared DNA purity parameters across the different DNA yield *** Our cohort included 49% male patients,aged 67.02 ± 8.38 *** 22G needle was used in 71%of the *** DNA parameters across our samples varied as follows:DNA yield:1289 ng(inter quartile range:534.75-3101),A260/280 = 1.85(1.79-1.86),A260/230 = 2.2(1.72-2.36).DNA yield was > 10 ng in all samples and > 100 ng in 93% of them(one sample < 50 ng).There were no significant differences in the concentration and A260/280 between samples by needle *** size was the only independent predictor of A260/230 which was higher in the 22G samples(P =0.038).NGS adequacy rate was 90% for 19G samples regardless of NGS type,and for 22G samples it reached 89% for WGS adequacy and 91% for WES and

关键词： Pancreatic adenocarcinoma Endoscopic ultrasound guided fine needle aspiration Next generation sequencing DNA yield Needle size Genetic testing

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Influence of hepatitis viruses on clinico-pathological profiles and long-term outcome in patients undergoing surgery for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 162-172页

作者： Anna-Maria Tanase Traian Dumitrascu Simona Dima Razvan Grigorie Agnes Marchio Pascal Pineau Irinel Popescu Center of General Surgery and Liver Transplant Fundeni Clinical Institute Unité "Organisation nucléaire et oncogenèse" INSERM U993Institut

BACKGROUND: The global risk of hepatocellular carcinoma(HCC) is largely due to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. In recent years, however, an increased prevalence of non-viral HCC has been noted. The clinical impact of the presence/absence of viral infections in HCC remains controversial. The present study aimed to assess the effect of hepatitis viruses on demographics, clinical and pathological features and long-term outcome in a large cohort of Romanian patients who underwent surgery for HCC. METHODS: The study included 404 patients with HCC who had undergone resection, transplantation or radiofrequency ablation at a single institution between 2001 and 2010. The patients were divided into four groups: 85 patients with hepatitis B virus infection (HBV group), 164 patients with hepatitis C virus infection (HCV group), 39 patients with hepatitis B and C virus co-infection (HBCV group), and 116 patients without viral infection (non-BC group). RESULTS: The patients of both HBV (56.0±11.3 years) and HBCV groups (56.0±9.9 years) were significantly younger than those of the HCV (61.0±8.5 years, P=0.001) and non-BC groups(61.0±13.0 years, P=0.002). Interestingly, the prevalence of liver cirrhosis was significantly lower in the non-BC group (47%)than in any other subsets (72%-90%, P<0.002). Furthermore, the non-BC patients were more advanced according to the Barcelona Clinic Liver Cancer stages than the patients of the HCV or HBCV groups (P<0.020); accordingly, they were more frequently assessed beyond the Milan criteria than any other groups (P=0.001). No significant differences in the disease-free or overall survival rates were observed among these groups. CONCLUSIONS: Patients with non-viral HCC are diagnosed at advanced ages and stages, a situation plausibly due to the poor effectiveness of cancer surveillance in community practice. The presence of viral infections does not appear to impair the longterm prognosis after surgical treatm

关键词： hepatitis B virus hepatitis Cvirus hepatocellular carcinoma recurrence prognosis

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Deliberate external pancreatic fistula after pancreaticoduodenectomy performed in the setting of acute pancreatitis, and its internalization through fistula-jejunostomy

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 94-96页

作者： Sorin T Alexandrescu Andrei C Zlate Razvan T Grigorie Mihnea Ionescu Irinel Popescu fundeni clinical institute Dan Setlacec Centre of General Surgery and Liver TransplantationSos.Fundeni nr.258sector 2BucharestRomania Carol Davila University of Medicine and Pharmacy BucharestRomania Titu Maiorescu University Faculty of MedicineBucharestRomania

To the Editor:Many patients with tumors of the pancreatic head or of the ampulla of Vater require endoscopic manipulation of the duodenal papilla in order to achieve tumor biopsy or for common bile duct *** interventional endoscopy approaches may lead to acute *** iatrogenic acute pancreatitis will influence the surgical strategy in patients scheduled for pancreaticoduodenectomy(PD).Due to the small number of cases,the surgical strategy in patients who require PD in the context of acute pancreatitis has not been standardized.

关键词： pancreatitis acute Vater

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