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Vertical hepatitis C virus transmission:Main questions and answers

World Journal of Hepatology 2014年第8期6卷 538-548页

作者： Grazia Tosone Alberto Enrico Maraolo Silvia Mascolo Giulia Palmiero Orsola Tambaro Raffaele Orlando Department of Clinical Medicine and surgery Section of Infectious Diseases University of Naples Federico Ⅱ 80131 Napoli Italy

Hepatitis C virus(HCV) affects about 3% of the world's population and peaks in subjects aged over 40 years. Its prevalence in pregnant women is low(1%-2%) in most western countries but drastically increases in women in developing countries or with high risk behav-iors for blood-transmitted infections. Here we review clinical, prognostic and therapeutic aspects of HCV in-fection in pregnant women and their offspring infected through vertical transmission. Pregnancy-related im-mune weakness does not seem to affect the course of acute hepatitis C but can affect the progression of chronic hepatitis C. In fact, postpartum immune res-toration can exacerbate hepatic inflammation, thereby worsening the liver disease, particularly in patients with liver cirrhosis. HCV infection increases the risk of gestational diabetes in patients with excessive weight gain, premature rupture of membrane and caesarean delivery. Only 3%-5% of infants born to HCV-positive mothers have been infected by intrauterine or perinatal transmission. Maternal viral load, human immunode-ficiency virus coinfection, prolonged rupture of mem-branes, fetal exposure to maternal infected blood con-sequent to vaginal or perineal lacerations and invasive monitoring of fetus increase the risk of viral transmis-sion. Cesarean delivery and breastfeeding increases the transmission risk in HCV/human immunodeficiency virus coinfected women. The consensus is not to offer antivi-ral therapy to HCV-infected pregnant women because it is based on ribavirin(pregnancy category X) because of its embryocidal and teratogenic effects in animal spe-cies. In vertically infected children, chronic C hepatitis is often associated with minimal or mild liver disease and progression to liver cirrhosis and hepatocarcinoma is lower than in adults. Infected children may be treated after the second year of life, given the adverse effects of current antiviral agents.

关键词： Hepatitis C infection Pregnancy Vertical transmission Antiviral therapy Prevention

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Atypical focal nodular hyperplasia of the liver

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Hepatobiliary & Pancreatic Diseases International 2011年第1期10卷 104-106页

作者： Muhammad Rizwan Khan Taimur Saleem Tanveer Ul Haq Kanwal Aftab section of General surgery Department of Surgery Aga Khan UniversityStadium Road Department of Pathology Aga Khan UniversityStadium Road section of Interventional Radiology Department of RadiologyAga Khan UniversityStadium Road Aga Khan University Hospital Medical College Aga Khan UniversityStadium Road

BACKGROUND:Focal nodular hyperplasia,a benign hepatic tumor,is usually ***,rarely the entity can cause symptoms,mandating intervention. METHOD:We present a case of focal nodular hyperplasia of the liver,which caused a considerable diagnostic dilemma due to its atypical presentation. RESULTS:A 29-year-old woman presented with a 15-year history of a progressively increasing mass in the right upper quadrant which was associated with pain and emesis. Examination showed a firm,mobile mass palpable below the right subcostal margin.A computed tomography scan of the abdomen showed an exophytic mass arising from hepatic segments III and *** biopsy of the hepatic mass was *** showed a vascular tumor that was supplied by a tortuous branch of the proper hepatic artery. Surgical intervention for removal of the mass was undertaken. Intra-operatively,two large discrete tumors were found and completely *** examination showed features consistent with focal nodular hyperplasia. CONCLUSION:This description of an unusual case of focal nodular hyperplasia of the liver highlights the point that the diagnosis of otherwise benign hepatic tumors may be difficult despite extensive work-up in some cases.

关键词： focal nodular hyperplasia atypical liver

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E2F transcription factors and digestive system malignancies: How much do we know?

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World Journal of Gastroenterology 2013年第21期19卷 3189-3198页

作者： Athanasios Xanthoulis Dina G Tiniakos Department of surgery Section of Gastroenterological SurgeryLevanger HospitalNord-Tr ndelag Hospital Trust7600 LevangerNorway Laboratory of Histology-Embryology Medical SchoolNational and Kapodistrian University of Athens11527 AthensGreece

E2F family of transcription factors regulates various cellular functions related to cell cycle and apoptosis. Its individual members have traditionally been classified into activators and repressors, based on in vitro studies. However their contribution in human cancer is more complicated and difficult to predict. We review current knowledge on the expression of E2Fs in digestive system malignancies and its clinical implications for patient prognosis and treatment. E2F1, the most extensively studied member and the only one with prognostic value, exhibits a tumor-suppressing activity in esophageal, gastric and colorectal adenocarcinoma, and in hepatocellular carcinoma (HCC), whereas in pancreatic ductal adenocarcinoma and esophageal squamous cell carcinoma may function as a tumorpromoter. In the latter malignancies, E2F1 immunohistochemical expression has been correlated with higher tumor grade and worse patient survival, whereas in esophageal, gastric and colorectal adenocarcinomas is a marker of increased patient survival. E2F2 has only been studied in colorectal cancer, where its role is not considered significant. E2F4's role in colorectal, gastric and hepatic carcinogenesis is tumor-promoting. E2F8 is strongly upregulated in human HCC, thus possibly contributing to hepatocarcinogenesis. Adenoviral transfer of E2F as gene therapy to sensitize pancreatic cancer cells for chemotherapeutic agents has been used in experimental studies. Other therapeutic strategies are yet to be developed, but it appears that targeted approaches using E2F-agonists or antagonists should take into account the tissue-dependent function of each E2F member. Further understanding of E2Fs' contribution in cellular functions in vivo would help clarify their role in carcinogenesis.

关键词： E2F Colorectal cancer Gastric cancer Esophageal cancer Pancreatic cancer Hepatocellular carcinoma Digestive system malignancies

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Reporting of dental status from full-arch radiographs: Descriptive analysis and methodological aspects

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World Journal of Clinical Cases 2014年第10期2卷 552-564页

作者： Fabian Huettig Detlef Axmann Department of Prosthodontics with section "Medical Materials and Technology" at the Centre of Dentistry Oral Medicine Maxillofacial Surgery of Eberhard-Karls-University Hospital

AIM: To identify standards, how entities of dental status are assessed and reported from full-arch radiographs of adults. METHODS: A Pub Med(Medline) search was performed in November 2011. Literature had to report at least one out of four defined entities using radiographs:number of teeth or implants; caries, fillings or restorations; root-canal fillings and apical health; alveolar bone level. Cohorts included to the study had to be of adult age. Methods of radiographic assessment were noted and checked for the later mode of report in text, tables or diagrams. For comparability, the encountered modeof report was operationalized to a logical ***: Thirty-seven out of 199 articles were evaluated via full-text review. Only one article reported all four entities. Eight articles reported at the maximum 3 comparable entities. However, comparability is impeded because of the usage of absolute or relative frequency, mean or median values as well as grouping. Furthermore the methods of assessment were different or not described sufficiently. Consequently, established sum scores turned out to be highly questionable, too. The amount of missing data within all studies remained unclear. It is even so remissed to mention supernumerary and aplased teeth as well as the count of third ***: Data about dental findings from radiographs is, if at all possible, only comparable with serious limitations. A standardization of both, assessing and reporting entities of dental status from radiographs is missing and has to be established within a report guideline.

关键词： Research design Guideline Dental radiography Epidemiology Public health EQUATOR

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Pan-enteric dysmotility,impaired quality of life and alexithymia in a large group of patients meeting ROMEⅡ criteria for irritable bowel syndrome

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World Journal of Gastroenterology 2003年第10期9卷 2293-2299页

作者： Piero Portincasa Antonio Moschetta Giuseppe Baldassarre Donato F. Altomare Giuseppe Palasciano section of Internal Medicine Department of Internal Medicine and Public Medicine(DIMIMP)University Medical SchoolBari Division of Geriatrics Hospital"Miulli"Acquaviva delle FontiBariItaly section of-surgery Department of Emergency and Organ Transplant(DETO)University Medical SchoolBariItaly

AIM:Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern ***: One hundred IBS patients (F:M=73:27, age 48±2 years, mean±SE) fulfilling ROME Ⅱ criteria matched with 100 healthy subjects (F:M=70:30, 45±2 years). Dyspepsia,bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT)were measured respectively by ultrasonography and H2-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue ***: Compared with controls, IBS patients had increased dyspepsia (score 12.6±0.7 VS 5.1±0.2, P＜0.0001),weekly bowel movements (12.3±0.4 VS 5.5±0.2, P＜0.00001, comparable stool shape), alexithymia (score 59.11.1 VS40.5±1.0, P=0.001), poor quality of life and psychoaffective profile. IBS patients had normal gallbladderemptying, but delayed gastric emptying (T50:35.5±1.0 VS 26.1±0.6 min, P=0.00001) and OCTT (163.0±5.4 VS96.6±1.8min, P=0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in ***: ROME Ⅱ IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of *** presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recoveed after therapy.

关键词：肠易激综合征述情障碍生活质量临床研究

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Liver graft procurement in neurologically deceased donor:Hospital Italiano of Buenos Aires approach

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 80-82页

作者： Juan Glinka Carolina Vanetta Juan Pekolj Juan Mattera Eduardo de Santibañes Martín de Santibañes Department of General surgery Hospital Italiano de Buenos AiresBuenos AiresArgentina section of HPB surgery&Liver Transplantation Unit Hospital Italiano de Buenos AiresBuenos AiresArgentina

To the Editor:Liver procurement(LP)from a neurologically deceased donor(NDD)is one of the most important spotlights in liver transplanta-tion(LT)[1,2].The commonly used approaches include the“rapid”en-bloc dissection,the in vivo normothermic dissection,or a com-bination of both,according to the preferences and/or the experi-ence of the LP/LT team.A correct LP is essential to achieve optimal *** the counterpart,defective execution of any of its steps can leave the liver graft unusable and/or cause severe complica-tions in the recipient[3].

关键词： Liver neurological dissection

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Post photorefractive keratectomy corneal ectasia

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International Journal of Ophthalmology(English edition) 2017年第2期10卷 315-317页

作者： Anna M Roszkowska Margherita S Sommario Mario Urso Pasquale Aragona Cornea and Refractive surgery section Ophthalmology UnitDepartment of Specialized SurgeriesUniversity Hospital of MessinaMessina 98125Italy

Dear Editor,We write to describe two cases of corneal ectasia occurred after photorefractive *** to the wide diffusion of refractive surgery,many ophthalmologists attempted to identify the risk factors and prevention ... 详细信息

关键词： PRK Post photorefractive keratectomy corneal ectasia Figure

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Updates in penile prosthesis infections

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Asian Journal of Andrology 2020年第1期22卷 28-33页

作者： Amanda R Swanton Ricardo M Munarriz Martin S Gross Department of surgery Section of UrologyDartmouth-Hitchcock Medical CenterLebanonNH 03766USA Department of Urology Boston Medical CenterBostonMA02118USA

Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile *** of the major complications associated with these prostheses is infections,which ultimately require device explanation and placement of a new *** the past several decades,significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient *** article reviews the current state of knowledge surrounding penile prosthesis infections,with attention to the evidence for methods to prevent infection and best practices for device reimplantation.

关键词： erectile dysfunction infection penile prosthesis

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Management of mucinous cystic neoplasms of the pancreas

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World Journal of Gastroenterology 2010年第45期16卷 5682-5692页

作者： Mario Testini Angela Gurrado Germana Lissidini Pietro Venezia Luigi Greco Giuseppe Piccinni Unit of Endocrine Digestive and Emergency SurgeryDepartment of Biomedical Sciences and Human OncologySection of General and Oncologic SurgeryUniversity Medical School of Bari70124 BariItaly Department of Emergency and Organ Transplantation University Medical School of Bari70124 BariItaly

The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. surgery is indicated for all MCNs.

关键词： Pancreatic cystic lesion Pancreatic mucinous cystic neoplasm Pancreatic mucin-producing cysts Pancreatic cystic neoplasm Pancreatic ovarian-type stroma

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Development of minimally invasive techniques for management of medically-complicated obesity

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World Journal of Gastroenterology 2014年第37期20卷 13424-13445页

作者： Farzin Rashti Ekta Gupta Suzan Ebrahimi Timothy R Shope Timothy R Koch Christopher J Gostout section of Gastroenterology and Hepatology MedStar-Washington Hospital Center and Georgetown University Schoolof Medicine Department of surgery MedStar-Washington Hospital CenterCenter for Advanced Laparoscopic and Bariatric Surgery Division of Gastroenterology and Hepatology Mayo Medical School

The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal inter-ventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss.

关键词： Obesity Bariatrics Bariatric surgery Weight loss Endoscopy

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