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1Non-invasive assessment of liver fibrosis in chronic hepatitis B显示文摘The goal of this review is to provide a comprehensive picture of the role,clinical applications and future perspectives of the most widely used non-invasive techniques for the evaluation of hepatitis B virus(HBV)infection.During the past decade many non-invasive methods have been developed to reduce the need for liver biopsy in staging fibrosis and to overcome whenever possible its limitations,mainly:invasiveness,costs,low reproducibility,poor acceptance by patients.Elastographic techniques conceived to assess liver stiffness,in particular transient elastography,and the most commonly used biological markers will be assessed against their respective role and limitations in staging hepatic fibrosis.Recent evidence highlights that both liver stiffness and some bio-chemical markers correlatewith survival and major clinical end-points such as liver decompensation,development of hepatocellular carcinoma and portal hypertension.Thus the non-invasive techniques here discussed can play a major role in the management of patients with chronic HBV-related hepatitis.Given their prognostic value,transient elastography and some bio-chemical markers can be used to better categorize patients with advanced fibrosis and cirrhosis and assign them to different classes of risk for clinically relevant outcomes.Very recent data indicates that the combined measurements of liver and spleen stiffness enable the reliable prediction of portal hypertension and esophageal varices development.Federica Branchi Clara Benedetta Conti Alessandra Baccarin Pietro Lampertico Dario Conte Mirella Fraquelli 2014World Journal of Gastroenterology2014,20,40:20
2Biliary complications after liver transplantation:current perspectives and future strategies显示文摘Importance:Liver transplantation(LT)is a life-saving therapy for patients with end-stage liver disease and with acute liver failure,and it is associated with excellent outcomes and survival rates at 1 and 5 years.The incidence of biliary complications(BCs)after LT is reported to range from 5%to 20%,most of them occurring in the first three months,although they can occur also several years after transplantation.Objective:The aim of this review is to summarize the available evidences on pathophysiology,risk factors,diagnosis and therapeutic management of BCs after LT.Evidence Review:a literature review was performed of papers on this topic focusing on risk factors,classifications,diagnosis and treatment Findings:Principal risk factors include surgical techniques and donor’s characteristics for biliary leakage and anastomotic biliary strictures and vascular alterations for non-anastomotic biliary strictures.MRCP is the gold standard both for intra-and extrahepatic BCs,while invasive cholangiography should be restricted for therapeutic uses or when MRCP is equivocal.About treatment,endoscopic techniques are the first line of treatment with success rates of 70-100%.The combined success rate of ERCP and PTBD overcome 90%of cases.Biliary leaks often resolve spontaneously,or with the positioning of a stent in ERCP for major bile leaks Conclusions and Relevance:BCs influence morbidity and mortality after LT,therefore further evidences are needed to identify novel possible risk factors,to understand if an immunological status that could lead to their development exists and to compare the effectiveness of innovative surgical and machine perfusion techniques.Bianca Magro Matteo Tacelli Alessandra Mazzola Filomena Conti Ciro Celsa 2021Hepatobiliary Surgery and Nutrition2021,10,1:12
3Diagnostic techniques for photonic materials based on Raman and Brillouin spectroscopies显示文摘The elastic and vibrational properties of a material,bulk or planar waveguide,are studied by Brillouin and Raman spectroscopy to follow the process of nanocrystals growth in glass-ceramics. The nanoparticles cause the appearance,in the low fre-quency Raman spectrum,of characteristic peaks,whose position depends on the size of the crystals. At the same time,sharp crystal peaks,due to optical phonons,appear in the Raman spectra,allowing the determination of the nucleated phase,and a frequency shift of the Brillouin peaks is observed.M. Mattarelli S.Caponi A. Chiappini M. Montagna E. Moser F. Rossi C.Tosello C. Armellini A. Chiasera M. Ferrari Y. Jestin G. Nunzi Conti S. Pelli G.C. Righini 2007Optoelectronics Letters2007,3,3:11
4Electrical storm: A clinical and electrophysiological overview显示文摘Electrical storm(ES) is a clinical condition characterized by three or more ventricular arrhythmia episodes leading to appropriate implantable cardioverterdefibrillator(ICD) therapies in a 24 h period. Mostly, arrhythmias responsible of ES are multiple morphologies of monomorphic ventricular tachycardia(VT), but polymorphic VT and ventricular fibrillation can also result in ES. Clinical presentation is very dramatic in most cases, strictly related to the cardiac disease that may worsen electrical and hemodynamic decompensation. Therefore ES management is challenging in the majority of cases and a high mortality is the rule both in the acute and in the long-term phases. Different underlying cardiomyopathies provide significant clues into the mechanism of ES, which can arise in the setting of structural arrhythmogenic cardiomyopathies or rarely in patients with inherited arrhythmic syndrome, impacting on pharmacological treatment, on ICD programming, and on the opportunity to apply strategies of catheter ablation. This latter has become a pivotal form of treatment due to its high efficacy in modifying the arrhythmogenic substrate and in achieving rhythm stability, aiming at reducing recurrences of ventricular arrhythmia and at improving overall survival. In this review, the most relevant epidemiological and clinical aspects of ES, with regard to the acute and long-term follow-up implications, were evaluated, focusing on these novel therapeutic strategies of treatment.Sergio Conti Salvatore Pala Viviana Biagioli Giuseppe Del Giorno Martina Zucchetti Eleonora Russo Vittoria Marino Antonio Dello Russo Michela Casella Francesca Pizzamiglio Valentina Catto Claudio Tondo Corrado Carbucicchio 2015World Journal of Cardiology2015,7,9:9
5Endoscopic management of gastrointestinal leaks and fistulae: Whatoption do we have?显示文摘Gastrointestinal leaks and fistulae are serious, potentially life threateningconditions that may occur with a wide variety of clinical presentations. Leaks aremostly related to post-operative anastomotic defects and are responsible for animportant share of surgical morbidity and mortality. Chronic leaks and longstanding post-operative collections may evolve in a fistula between twoepithelialized structures. Endoscopy has earned a pivotal role in the managementof gastrointestinal defects both as first line and as rescue treatment. Endotherapyis a minimally invasive, effective approach with lower morbidity and mortalitycompared to revisional surgery. Clips and luminal stents are the pioneer ofgastrointestinal (GI) defect endotherapy, whereas innovative endoscopic closuredevices and techniques, such as endoscopic internal drainage, suturing systemand vacuum therapy, has broadened the indications of endoscopy for themanagement of GI wall defect. Although several endoscopic options are currentlyused, a standardized evidence-based algorithm for management of GI defect isnot available. Successful management of gastrointestinal leaks and fistulaerequires a tailored and multidisciplinary approach based on clinical presentation,defect features (size, location and onset time), local expertise and the availabilityof devices. In this review, we analyze different endoscopic approaches, which weselected on the basis of the available literature and our own experience. Then, weevaluate the overall efficacy and procedural-specific strengths and weaknesses ofeach approach.Fabrizio Cereatti Roberto Grassia Andrea Drago Clara Benedetta Conti Gianfranco Donatelli 2020World Journal of Gastroenterology2020,26,29:8
6Ultrasound elastographic techniques in focal liver lesions显示文摘Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.Clara Benedetta Conti Federica Cavalcoli Mirella Fraquelli Dario Conte Sara Massironi 2016World Journal of Gastroenterology2016,22,9:6
7The HEPD particle detector of the CSES satellite mission for investigating seismo-associated perturbations of the Van Allen belts显示文摘CSES(China Seismo-Electromagnetic Satellite) is a mission developed by CNSA(Chinese National Space Administration) and ASI(Italian Space Agency), to investigate the near-Earth electromagnetic, plasma and particle environment, for studying the seismo-associated disturbances in the ionosphere-magnetosphere transition zone. The anthropogenic and electromagnetic noise,as well as the natural non-seismic electromagnetic emissions is mainly due to tropospheric activity. In particular, the mission aims to confirming the existence of possible temporal correlations between the occurrence of earthquakes for medium and strong magnitude and the observation in space of electromagnetic perturbations, plasma variations and precipitation of bursts with highenergy charged particles from the inner Van Allen belt. In this framework, the high energy particle detector(HEPD) of the CSES mission has been developed by the Italian LIMADOU Collaboration. HEPD is an advanced detector based on a tower of scintillators and a silicon tracker that provides good energy and angular resolution and a wide angular acceptance, for electrons of 3–100 Me V, protons of 30–200 Me V and light nuclei up to the oxygen. CSES satellite has been launched on February 2^(nd), 2018 from the Jiuquan Satellite Launch Center(China).AMBROSI Giovanni BARTOCCI Simona BASARA Laurent BATTISTON Roberto BURGER William J. CARFORA Luca CASTELLINI Guido CIPOLLONE Piero CONTI Livio CONTIN Andrea DE DONATO Cinzia DE SANTIS Cristian FOLLEGA Francesco M. GUANDALINI Cristina IONICA Maria IUPPA Roberto LAURENTI Giuliano LAZZIZZERA Ignazio LOLLI Mauro MANEA Christian MARCELLI Laura MASCIANTONIO Giuseppe MERGE Matteo OSTERIA Giuseppe PACINI Lorenzo PALMA Francesco PALMONARI Federico PANICO Beatrice PATRIZII Laura PERFETTO Francesco PICOZZA Piergiorgio POZZATO Michele PUEL Matteo RASHEVSKAYA Irina RICCI Ester RICCI Marco RICCIARINI Sergio Bruno SCOTTI Valentina SOTGIU Alessando SPARVOLI Roberta SPATARO Bruno VITALE Vincenzo 2018Science China(Technological Sciences)2018,61,5:6
8Liver grafts from hepatitis B surface antigen-positive donors: A review of the literature显示文摘The scarcity of available organs and the gap between supply and demand continue to be the main limitations of liver transplantation. To relieve the organ shortage, current transplant strategies have implemented extended criteria, which include the use of liver from patients with signs of past or present hepatitis B virus(HBV) infection. While the use of liver grafts from donors with evidence of past HBV infection is quite limited, some data have been collected regarding the feasibility of transplanting a liver graft from a hepatitis B surface antigen(HBs Ag) positive donor. The aim of the present work was to review the literature regarding liver transplants from HBs Ag-positive donors. A total of 17 studies were identified by a search in Medline. To date, HBs Ag positive grafts have preferentially been allocated to HBs Ag positive recipients. The large majority of these patients continue to be HBs Ag positive despite the use of immunoglobulin, and infection prevention can only be guaranteed by using antiviral prophylaxis. Although serological persistence is evident, no significant HBV-related disease has been observed, except in patients coinfected with delta virus. Consistently less data are available for HBs Ag negative recipients, although they are mostly promising. HBs Agpositive grafts could be an additional organ source for liver transplantation, provided that the risk of reinfection/reactivation is properly prevented.Elisabetta Loggi Fabio Conti Alessandro Cucchetti Giorgio Ercolani Antonio Daniele Pinna Pietro Andreone 2016World Journal of Gastroenterology2016,22,35:5
9Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age显示文摘AIM To report the clinical and radiographic results of titanium elastic nail(TEN) in diaphyseal femoral fractures of children below age of six years.METHODS A retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn's scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion(ROM), functional status, complications, and parent's satisfaction.RESULTS Sixteen males and eight females with a mean age of 3.2 years at the time of treatment were re-evaluated at an average follow-up of 58.9 mo. No cases of delayed union were observed. The mean limb lengthening was 0.3 cm. Four cases experienced limb lengthening greater than 1 cm and always minor than 2 cm. Twelve point five percent of the cases showed an angulation < 10°. Complete functional recovery(hip and knee ROM, ability to run and jump on the operated limb) occurred in 95.7% of cases. Complications included two cases of superficial infection of the TEN entry point, one case of refracture following a new trauma, and one TEN mobilization. According to the Flynn's scoring criteria, excellent results were obtained in 79.2% of patients and satisfactory results in the remaining 20.8%, with an average parent's satisfaction level of 9.1/10.CONCLUSION TEN is as a safe, mini-invasive and surgeon-friendly technique and, considering specific inclusion criteria, it represents a useful and efficacy option for the treatment of diaphyseal femoral fractures even in patients younger than six years of age.Fabrizio Donati Giuseppe Mazzitelli Marco Lillo Amerigo Menghi Carla Conti Antonio Valassina Emanuele Marzetti Giulio Maccauro 2017World Journal of Orthopedics2017,8,2:5
102014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society显示文摘Craig T. January L. Samuel Wann Joseph S. Alpert Hugh Calkins Joaquin E. Cigarroa Joseph C. Cleveland Jamie B. Conti Patrick T. Ellinor Michael D. Ezekowitz Michael E. Field Katherine T. Murray Ralph L. Sacco William G. Stevenson Patrick J. Tchou Cynthia 2014Circulation2014,,23:4
11Impact of age on feasibility and short-term outcomes of ERAS after laparoscopic colorectal resection显示文摘BACKGROUND There is still large debate on feasibility and advantages of fast-track protocols in elderly population after colorectal surgery.AIM To investigate the impact of age on feasibility and short-term results of enhanced recovery protocol(ERP)after laparoscopic colorectal resection.METHODS Data from 225 patients undergoing laparoscopic colorectal resection and ERP between March 2014 and July 2018 were retrospectively analyzed.Three groups were considered according to patients’age:Group A,65 years old or less,Group B,66 to 75 years old and Group C,76 years old or more.Clinic and pathological data were compared amongst groups together with post-operative outcomes including post-operative overall and surgery-specific complications,mortality and readmission rate.Differences in post-operative length of stay and adherence to ERP’s items were evaluated in the three study groups.RESULTS Among the 225 patients,112 belonged to Group A,57 to Group B and 56 to Group C.Thirty-day overall morbidity was 32.9%whilst mortality was nihil.Though the percentage of complications progressively increased with age(25.9%vs 36.8%vs 42.9%),no differences were observed in the rate of major complications(4.5%vs 3.5%vs 1.8%),prolonged post-operative ileus(6.2%vs 12.2%vs 10.7%)and anastomotic leak(2.7%vs 1.8%vs 1.8%).Significant differences in recovery outcomes between groups were observed such as delayed urinary catheter removal(P=0.032)and autonomous deambulation(P=0.013)in elderly patients.Although discharge criteria were achieved later in older patients(3 d vs 3 d vs 4 d,P=0.040),post-operative length of stay was similar in the 3 groups(5 d vs 6 d vs 6 d).CONCLUSION ERPs can be successfully and safely applied in elderly undergoing laparoscopic colorectal resection.Corrado Pedrazzani Cristian Conti Giulia Turri Enrico Lazzarini Marzia Tripepi Giovanni Scotton Matteo Rivelli Alfredo Guglielmi 2019World Journal of Gastrointestinal Surgery2019,11,10:4
12Diagnostic yield of EUS-FNA of small(≤15 mm) solid pancreatic lesions using a 25-gauge needle显示文摘Background: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.Methods: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups(≤15 mm, 16–25 mm and >25 mm), and the outcomes were compared.Results: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%,81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size(P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor(P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate(P = 0.018, OR = 1.08).Conclusion: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.Stefano Francesco Crinò Maria Cristina Conti Bellocchi Laura Bernardoni Erminia Manfrin Alice Parisi Antonio Amodio Nicolò De Pretis Luca Frulloni Armando Gabbrielli 2018Hepatobiliary & Pancreatic Diseases International2018,17,1:4
13如何成为一名优秀的医生显示文摘Conti教授为美国佛罗里达大学教授,曾任心内科和内科主任。美国心脏病学学院前主席,美国临床心脏病学杂志总编辑,心脏病学院影像出版总编辑。Conti教授十分关心中国心血管事业的发展,曾多次访华和做学术报告,并任同济大学医学院名誉教授。Conti教授这一文章言简意赅,说明了临床医师成长和临床工作中一些主要的原则,值得我们深思:在现代医学条件下,是否只要外文棒、会上网检索最近的循证医学信息就能满足临床工作要求、就能成为一名好医生?另一方面,是否只要拼时间、熬年头,随着临床工作年限的增长自然会成为有经验的好医师?随着现代检查项目的创新和发展,详细地询问病史、体检还有没有必要?是不是浪费时间?各种辅助检查是否做得越多、越全面、越先进才能表明一名医生、一个单位的医疗水平高?效益好?总之,过去所强调的临床工作中的“三基三严”是否还有现实意义?Conti教授作为美国心血管界的泰斗,应当是站在临床医学现代化最前沿的领军人物,来自他毕生医疗实践的心得应对我们有所启迪。C.Richard Conti 周福德 王海燕 2005中华内科杂志2005,44,9:3
14直接抗病毒药物治疗的丙型肝炎肝硬化患者肝癌的早期发生和复发情况显示文摘肝癌是丙型肝炎肝硬化的严重并发症。新型直接抗病毒药物(DAA)能治愈90%的丙型肝炎患者。本研究旨在评估DAA治疗的丙型肝炎肝硬化患者中肝癌的早期发生和复发情况。来自波罗尼亚大学的Conti等连续地分析了344例应用DAA治疗、无肝癌的肝硬化患者,随访24周。其中包括59例随访前曾经发生过肝癌(现已治愈)的患者。DAA治疗达到了91%的持续病毒学应答。Conti F 刘苗霞 温晓玉 2016临床肝胆病杂志2016,32,9:3
15离子通道疗法在缺血性心脏病治疗中的应用显示文摘基础研究显示有多种离子通道参与缺血性心脏病的发病机制,包括L型钙通道、T型钙通道、ATP敏感性钾通道、内向钠钾电流通道和晚钠电流通道。临床研究发现调控这些通道的功能可以改善心肌供血和心肌细胞代谢。本文对离子通道生物学研究作一简要论述,同时对不同离子通道阻滞剂缺血性心脏病治疗中的应用进行回顾总结,以期临床重视这类药物的研究和应用。C. Richard Conti 2012中华心血管病杂志2012,40,3:3
16Endoscopic ultrasound diagnostic gain over computed tomography and magnetic resonance cholang-iopancreatography in defining etiology of idiopathic acute pancreatitis显示文摘BACKGROUND About 10%-30%of acute pancreatitis remain idiopathic(IAP)even after clinical and imaging tests,including abdominal ultrasound(US),contrast-enhanced computed tomography(CECT)and magnetic resonance cholangiopancreatography(MRCP).This is a relevant issue,as up to 20%of patients with IAP have recurrent episodes and 26%of them develop chronic pancreatitis.Few data are available on the role of EUS in clarifying the etiology of IAP after failure of one or more cross-sectional techniques.AIM To evaluate the diagnostic gain after failure of one or more previous crosssectional exams.METHODS We retrospectively collected data about consecutive patients with AP and at least one negative test between US,CECT and MRCP,who underwent linear EUS between January 2017 and December 2020.We investigated the EUS diagnostic yield and the EUS diagnostic gain over different combinations of these crosssectional imaging techniques for the etiologic diagnosis of AP.Types and frequency of EUS diagnosis were also analyzed,and EUS diagnosis was compared with the clinical parameters.After EUS,patients were followed-up for a median of 31.5 mo to detect cases of pancreatitis recurrence.RESULTS We enrolled 81 patients(63%males,mean age 61±18,23%with previous cholecystectomy,17%with recurrent pancreatitis).Overall EUS diagnostic yield for AP etiological diagnosis was 79%(20%lithiasis,31%acute on chronic pancreatitis,14%pancreatic solid or cystic lesions,5%pancreas divisum,5%autoimmune pancreatitis,5%ductal abnormalities),while 21%remained idiopathic.US,CECT and MRCP,taken alone or in combination,led to AP etiological diagnosis in 16(20%)patients;among the remaining 65 patients,49(75%)obtained a diagnosis at EUS,with an overall EUS diagnostic gain of 61%.Sixty-eight patients had negative US;among them,EUS allowed etiological diagnosis in 59(87%).Sixty-three patients had a negative CECT;among them,47(74%)obtained diagnosis with EUS.Twenty-four had a negative MRCP;among them,20(83%)had EUS diagnosis.Twenty-one had negative CT+MRCP,of which 17(81%)had EUS diagnosis,with a EUS diagnostic gain of 63%.Patients with biliary etiology and without previous cholecystectomy had higher median values of alanine aminotransferase(154 vs 25,P=0.010),aspartate aminotransferase(95 vs 29,P=0.018),direct bilirubin(1.2 vs 0.6,P=0.015),gammaglutamyl transpeptidase(180 vs 48,P=0.006)and alkaline phosphatase(150 vs 72,P=0.015)Chronic pancreatitis diagnosis was more frequent in patients with recurrent pancreatitis at baseline(82%vs 21%,P<0.001).During the follow-up,AP recurred in 3 patients,one of which remained idiopathic.CONCLUSION EUS is a good test to define AP etiology.It showed a 63%diagnostic gain over CECT+MRCP.In suitable patients,EUS should always be performed in cases of IAP.Further prospective studies are needed.Stefano Mazza Biagio Elvo Clara Benedetta Conti Andrea Drago Maria Chiara Verga Sara Soro Annalisa De Silvestri Fabrizio Cereatti Roberto Grassia 2022World Journal of Gastrointestinal Endoscopy2022,14,6:3
17Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients显示文摘Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center.Patients were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI<25;Group A),overweight(25≤BMI<30;Group B)and obese(BMI≤30;Group C),for a total of 412 patients evaluable for this study.Preoperative total serum prostate-specific antigen(PSA),digital rectal examination of the prostate,transrectal ultrasound(TRUS),renal ultrasound,urine culture,uroflowmetry,International Prostate Symptoms Score(IPSS),and Quality of Life(QoL)score were analyzed.Post-operative complications,hospital stay and days of catheterization,questionnaires and uroflowmetry at 1 and 3 months after surgery were evaluated.Preoperative data,surgical outcomes,complication rate and clinical outcomes were compared between groups.Results:The median age of patients was 69 years(Interquartile Range[IQR 10]).The preoperative median IPSS among groups was 19(IQR 8.75),20(IQR 10),and 18(IQR 10)respectively.At 1 and 3 months of follow-up,this value was 8(IQR 7),8(IQR 4),7(IQR 5)and 5(IQR 6.25),5(IQR 6),6(IQR 5),respectively(all p between groups>0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.Luca Carmignani Maria Chiara Clementi Claudia Signorini Gloria Motta Sebastiano Nazzani Franco Palmisano Elisa De Lorenzis Michele Catellani Alessandro Francesco Mistretta Andrea Conti Valeria Tringali Maria Beatrice Costa Damiano Vizziello 2019Asian Journal of Urology2019,6,3:3
18Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery:An algorithmic approach显示文摘AIM:To investigate injuries of anatomy variants of hepatic duct confluence during hepatobiliary surgery and their impact on morbidity and mortality of these procedures. An algorithmic approach for the management of these injuries is proposed. METHODS:During a 6-year period 234 patients who had undergone major hepatobiliary surgery were retrospectively reviewed in order to study postoperative bile leakage. Diagnostic workup included endoscopic and magnetic retrograde cholangiopancreatography (E/MRCP), scintigraphy and fistulography. RESULTS:Thirty (12.8%) patients who developed postoperative bile leaks were identified. Endoscopic stenting and percutaneous drainage were successful in 23 patients with bile leaks from the liver cut surface. In the rest seven patients with injuries of hepatic duct confluence, biliary variations were recognized and a stepwise therapeutic approach was considered. Conservative management was successful only in 2 patients. Volume of the liver remnant and functional liver reserve as well as local sepsis were used as criteria for either resection of the corresponding liver segment or construction of a biliary-enteric anastomosis. Two deaths occurred in this group of patients with hepatic duct confluence variants (mortality rate 28.5%). CONCLUSION:Management of major biliary fistulaethat are disconnected from the mainstream of the biliary tree and related to injury of variants of the hepatic duct confluence is extremely challenging. These patients have a grave prognosis and an early surgical procedure has to be considered.Georgios Fragulidis Athanasios Marinis Andreas Polydorou Christos Konstantinidis Georgios Anastasopoulos John Contis Dionysios Voros Vassilios Smyrniotis 2008World Journal of Gastroenterology2008,14,19:3
19NGF, DCX, and NSE upregulation correlates with severity and outcome of head trauma in children显示文摘A Chiaretti G Barone R Riccardi A Antonelli P Pezzotti O Genovese L Tortorolo G Conti 2009Neurology2009,,7:3
20Pericyte-like differentiation of human adipose-derived mesenchymal stem cells:An in vitro study显示文摘BACKGROUND Adipose-derived mesenchymal stem cells(ASCs)are characterized by long-term self-renewal and a high proliferation rate.Under adequate conditions,they may differentiate into cells belonging to mesodermal,endodermal or ectodermal lineages.Pericytes support endothelial cells and play an important role in stabilizing the vessel wall at the microcirculation level.The loss of pericytes,as occurs in diabetic retinopathy,results in a breakdown of the blood-retina barrier(BRB)and infiltration of inflammatory cells.In this context,the use of pericytelike differentiated ASCs may represent a valuable therapeutic strategy for restoring BRB damage.AIM To test in vitro strategies to obtain pericyte-like differentiation of human ASCs(hASCs).METHODS Different culture conditions were tested:hASCs cultured in a basal medium supplemented with transforming growth factorβ1;and hASCs cultured in a specific pericyte medium(PM-hASCs).In a further sample,pericyte growth supplement was omitted from the PM.In addition,cultures of human retinal pericytes(hRPCs)were used for comparison.Pericyte-like differentiation of hASCs was tested by immunocytochemical staining and western blotting to evaluate the expression ofα-smooth muscle actin(α-SMA)and neural/glial antigen 2(NG2).Interactions between human retinal endothelial cells(hRECs)and different groups of hASCs were investigated in co-culture experiments.In these cases,the expression of typical junctional proteins such as vascular endothelial-Cadherin,zonula occludens-1 and Occludin were assessed in hRECs.In an in vitro model of the BRB,values of trans-endothelial electrical resistance were measured when hRECs were co-cultured with various groups of pretreated hASCs.The values observed were compared with co-cultures of hRECs and hRPCs as well as with cultures of hRECs alone.Three-dimensional co-cultures of hRECs and hRPCs or pericyte-like hASCs in Matrigel were designed to assess their reciprocal localization.RESULTS After 3-6 d of culture,α-SMA and NG2 immunocytochemistry showed that the closest pericyte-like phenotype was observed when hASCs were cultured in Pericyte Medium(PM-hASCs).In particular,α-SMA immunoreactivity,already visible at the basal level in pericytes and ASCs,was strongly increased only when transforming growth factor was added to the culture medium.NG2 expression,almost undetectable in most conditions,was substantially increased only in PMhASCs.Immunocytochemical results were confirmed by western blot analysis.The presence of pericyte growth supplement seems to increase NG2 expression rather thanα-SMA,in agreement with its role in maintaining pericytes in the proliferative state.In co-culture experiments,immunoreactivity of vascular endothelial-Cadherin,zonula occludens-1 and Occludin was considerably increased in hRECs when hRPCs or PM-hASCs were also present.Supporting results were found by trans-endothelial electrical resistance measurements,gathered at 3 and 6 d of co-culture.The highest resistance values were obtained when hRECs were co-cultured with hRPCs or PM-hASCs.The pericyte-like phenotype of PM-hASCs was also confirmed in three-dimensional co-cultures in Matrigel,where PM-hASCs and hRPCs similarly localized around the tubular formations made by hRECs.CONCLUSION PM-hASCs seem able to strengthen the intercellular junctions between hRECs,likely reinforcing the BRB;thus,hASC-based therapeutic approaches may be developed to restore the integrity of retinal microcirculation.Giuliana Mannino Florinda Gennuso Giovanni Giurdanella Federica Conti Filippo Drago Salvatore Salomone Debora Lo Furno Claudio Bucolo Rosario Giuffrida 2020World Journal of Stem Cells2020,12,10:3
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