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| 1 | Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease显示文摘After the first description of fatty pancreas in 1933,the effects of pancreatic steatosis have been poorly investigated,compared with that of the liver. However,the interest of research is increasing. Fat accumulation,associated with obesity and the metabolic syndrome(Met S),has been defined as 'fatty infiltration' or 'nonalcoholic fatty pancreas disease'(NAFPD). The term 'fatty replacement' describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity,increasing age,male sex,hypertension,dyslipidemia,alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus,Met S,atherosclerosis,severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of 'ectopic fat deposition',which is a key element of nonalcoholic fatty liver disease and/or Met S. Moreover,in patients with fatty pancreas,pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula. | Roberto Catanzaro Biagio Cuffari Angelo Italia Francesco Marotta | 2016 | World Journal of Gastroenterology2016，22，34： | 22 |
| 2 | Evaluation of the updated definition of early allograft dysfunction in donation after brain death and donation after cardiac death liver allografts显示文摘BACKGROUND:An updated definition of early allograft dysfunction(EAD) was recently validated in a multicenter study of 300 deceased donor liver transplant recipients.This analysis did not differentiate between donation after brain death(DBD) and donation after cardiac death(DCD) allograft recipients.METHODS:We reviewed our prospectively entered database for all DBD(n=377) and DCD(n=38) liver transplantations between January 1,2006 and October 30,2011.The incidence of EAD as well as its ability to predict graft failure and survival was compared between DBD and DCD groups.RESULTS:EAD was a valid predictor of both graft and patient survival at six months in DBD allograft recipients,but in DCD allograft recipients there was no significant difference in the rate of graft failure in those with EAD(11.5%) compared with those without EAD(16.7%)(P=0.664) or in the rate of death in recipients with EAD(3.8%) compared with those without EAD(8.3%)(P=0.565).The graft failure rate in the first 6 months in those with international normalized ratio ≥1.6 on day 7 who received a DCD allograft was 37.5% compared with 6.7% for those with international normalized ratio <1.6 on day 7(P=0.022).CONCLUSIONS:The recently validated definition of EAD is a valid predictor of patient and graft survival in recipients of DBD allografts.On initial assessment,it does not appear to be a useful predictor of patient and graft survival in recipients of DCD allografts,however a study with a larger sample size of DCD allografts is needed to confirm these findings.The high ALT/AST levels in most recipients of DCD livers as well as the predisposition to biliary complications and early cholestasis make these parameters as poor predictors of graft failure.An alternative definition of EAD that gives greater weight to the INR on day 7 may be more relevant in this population. | Kris P Croome William Wall Douglas Quan Sai Vangala Vivian McAlister Paul Marotta Roberto Hernandez-Alejandro | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，4： | 15 |
| 3 | Syringomyelia associated with cervical spondylosis: A rare condition显示文摘Spinal spondylosis is an extremely common condition that has only rarely been described as a cause of syringomyelia. We describe a case of syringomyelia associated with cervical spondylosis admitted at our division and treated by our institute. It is the case of a 66-yearold woman. At our observation she was affected by moderate-severe spastic tetraparesis. T2-weighted magnetic resonance imaging(MRI) showed an hyperintense signal within spinal cord from C3 to T1 with a more sharply defined process in the inferior cervical spinal cord. At the same level bulging discs, facets and ligamenta flava hypertrophy determined a compression towards subarachnoid space and spinal cord. Spinal cord compression was more evident in hyperextension rather than flexion. A 4-level laminectomy and subsequent posterior stabilization with intra-articular screws was executed. At 3-mo follow up there was a regression of tetraparesis but motor deficits of the lower limbs residuated. At the same follow up postoperative MRI was executed. It suggested enlargement of the syrinx. Perhaps hyperintensity within spinal cord appeared 'bounded' from C3 to C7 with clearer margins. At the level of surgical decompression, subarachnoid space and spinal cord enlargement were also evident. A review of the literature was executed using Pub Med database. The objective of the research was to find an etiopathological theory able to relate syringomyelia with cervical spondylosis. Only 6 articles have been found. At the origin of syringomyelia the mechanisms of compression and instability are proposed. Perhaps other studies assert the importance of subarachnoid space regard cerebrospinal fluid(CSF) dynamic. We postulate that cervical spine instability may be the cause of multiple microtrauma towards spinal cord and consequently may damage spinal cord parenchyma generating myelomalacia and consequently syrinx. Otherwise the hemorrhage within spinal cord central canal can cause an obstruction of CSF outflow, finally generating the syrinx. On the other hand in cervical spondylosis the stenotic elements can affect subarachnoid space. These elements rubbing towards spinal cord during movements of the neck can generate arachnoiditis, subarachnoid hemorrhages and arachnoid adhesions. Analyzing the literature these 'complications' of cervical spondylosis are described at the origin of syringomyelia. So surgical decompression, enlarging medullary canal prevents rubbings and contacts between the bone-ligament structures of the spine towards spinal cord and subarachnoid space therefore syringomyelia. Perhaps stabilization is also necessary to prevent instability of the cervical spine at the base of central cord syndrome or syringomyelia. Finally although patients affected by central cord syndrome are usually managed conservatively we advocate, also for them, surgical treatment in cases affected by advanced state of the symptoms and MRI. | Alessandro Landi Lorenzo Nigro Nicola Marotta Cristina Mancarella Pasquale Donnarumma Roberto Delfini | 2013 | World Journal of Clinical Cases2013，1，3： | 7 |
| 4 | Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis显示文摘 | Andrés Cárdenas Pere Ginès Paul Marotta Frank Czerwiec John Oyuang Mónica Guevara Nezam H Afdhal | 2011 | Journal of Hepatology2011，，3： | 6 |
| 5 | Magnetic resonance diffusion tensor imaging and fibertracking diffusion tensor tractography in the management of spinal astrocytomas显示文摘Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesions.FA measurements may are used to predicting the outcome of patients who have spinal cord lesions.Fiber tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or resection.In this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future. | Alessandro Landi Valeria Palmarini Alessandro D'Elia Nicola Marotta Maurizio Salvati Antonio Santoro Roberto Delfini | 2016 | World Journal of Clinical Cases2016，4，1： | 6 |
| 6 | A comparison of survival and pathologic features of non-alcoholic steatohepatitis and hepatitis C virus patients with hepatocellular carcinoma显示文摘AIM:To compare the clinical outcome and pathologic features of non-alcoholic steatohepatitis(NASH) patients with hepatocellular carcinoma(HCC) and hepatitic C virus(HCV) patients with HCC(another group in which HCC is commonly seen) undergoing liver transplantation.METHODS:Patients transplanted for HCV and NASH at our institution from January 2000 to April 2011 were analyzed.All explanted liver histology and pre-transplant liver biopsies were examined by two specialist liver histopathologists.Patient demographics,disease free survival,explant liver characteristics and HCC features(tumour number,cumulative tumour size,vascular invasion and differentiation) were compared between HCV and NASH liver transplant recipients.RESULTS:A total of 102 patients with NASH and 283 patients with HCV were transplanted.The incidence of HCC in NASH transplant recipients was 16.7%(17/102).The incidence of HCC in HCV transplant recipients was 22.6%(64/283).Patients with NASH-HCC were statistically older than HCV-HCC patients(P < 0.001).A significantly higher proportion of HCV-HCC patients had vascular invasion(23.4% vs 6.4%,P = 0.002) and poorly differentiated HCC(4.7% vs 0%,P < 0.001) compared to the NASH-HCC group.A trend of poorer recurrence free survival at 5 years was seen in HCV-HCC patients compared to NASH-HCC who underwent a Liver transplantation(P = 0.11).CONCLUSION:Patients transplanted for NASH-HCC appear to have less aggressive tumour features compared to those with HCV-HCC,which likely in part accounts for their improved recurrence free survival. | Roberto Hernandez-Alejandro Kris P Croome Martin Drage Nathalie Sela Jeremy Parfitt Natasha Chandok Paul Marotta Cheryl Dale William Wall Douglas Quan | 2012 | World Journal of Gastroenterology2012，18，31： | 5 |
| 7 | Trans-sacral screw fixation in the treatment of high dyplastic developmental spondylolisthesis显示文摘We describe the case of a 67-year-old woman with L5-S1 ontogenetic spondylolisthesis treated with pedicle fixation associated with interbody arthrodesis performed with S1-L5 trans-sacral screwing according to the technique of Bartolozzi. The procedure was followed by a wide decompressive laminectomy. The patient had a progressive improvement of the symptoms which gradually disappeared in 12 mo. The radiograph at 6 and 12 mo showed complete fusion system. The choice of treatment in L5-S1 ontogenetic spondylolithesis is related to a correct clinical and diagnostic planning(X-ray, computer tomography magnetic resonance imaging, Measurement). In particular, the severity index and the square of unstable zone, and the standard measurements already described in the literature, are important to understand and to plane the correct surgical strategy, that require, in most of the times, fusion and interbody artrodesis. | Alessandro Landi Nicola Marotta Cristina Mancarella Roberto Tarantino Roberto Delfini | 2013 | World Journal of Clinical Cases2013，1，3： | 4 |
| 8 | 360° fusion for realignment of high grade cervical kyphosis by one step surgery: Case report显示文摘Surgical treatment for cervical kyphotic deformity is still controversial. Circumferential approach has been well described in the literature but long terms outcomes are not well reported. Important to decide the correct treatment option is the preoperative radiological exams to value the type of deformity(flexible or fixed). We report the case of a 67-year-old woman affected by a severe cervical kyphotic deformity who underwent combined anterior/posterior surgical approach, getting a good reduction of the deformity and an optimal stability in a long term follow up. | Alessandro Landi Nicola Marotta Cristina Mancarella Demo Eugenio Dugoni Roberto Tarantino Roberto Delfini | 2014 | World Journal of Clinical Cases2014，2，7： | 4 |
| 9 | Reuse of liver grafts following the brain death of the initial recipient显示文摘AIM: To determine if there is a reasonable prospect of success of a re-use liver transplantation.METHODS: We systematically searched for reports of liver graft re-use using electronic searches of PubMed and Web of Knowledge. We performed hand searches of references lists of articles reporting re-use of grafts.RESULTS: A systematic review of the literature reveals 28 liver transplantations using previously transplanted grafts. First and second recipients ranged in age from 4 to 72 years and 29 to 62 years respectively. Liver disease in the first recipient was varied including 5(18%) patients with fulminant liver failure who died subsequently of cerebral edema. The second transplanta-tion was performed after a median interval of 5 d(one day-13 years). Viral hepatitis was present in 3(11%) of the initial recipients and in 8(29%) of final recipients. Hepatocellular carcinoma was present in 6(21%) of the final recipients. Early survival after the final transplantation was 93%, whereas long-term survival was 78% with a mean follow-up of 23.3(3-120) mo.CONCLUSION: Outcomes of transplantation using previously transplanted grafts in this select population are similar to those seen with conventional grafts. | Hideaki Tanaka Vivian C McAlister Mark A Levstik Cameron N Ghent Paul J Marotta Douglas Quan William J Wall | 2014 | World Journal of Hepatology2014，6，6： | 3 |
| 10 | Diagnostic accuracy of enhanced liver fibrosis test to assess liver fibrosis in patients with chronic hepatitis C显示文摘BACKGROUND:The prognosis and clinical management of patients with chronic liver diseases are closely related to the severity of liver fibrosis.Liver biopsy is considered the gold standard for the staging of liver fibrosis.However,it is an invasive test sometimes related to complications.This study aimed to assess the diagnostic value of enhanced liver fibrosis(ELF) test to predict liver fibrosis in patients with chronic hepatitis C.METHODS:This study included 162 patients with liver disease and 67 healthy controls.Hyaluronic acid,tissue inhibitor of matrix metalloproteinase type 1,and amino-terminal propeptide type III procollagen were measured by enzymelinked immunosorbent assay with the ELF test ADVIA Centaur(Siemens Healthcare Diagnostics Inc.).Fibrosis stage was determined using the Metavir scoring system.RESULTS:In our study,for the diagnosis of significant fibrosis(Metavir F≥2) a cut-off value >7.72 provides a sensitivity of 93.0% and a specificity of 83.0%.The areas under the receiver operator characteristic curve,sensitivity,specificity,and positive and negative predictive values were 0.94,93.3%,81.0%,93.3%,and 81.0%,respectively(P<0.001).For the diagnosis of cirrhosis(Metavir F=4) a cut-off value >9.3 provides a sensitivity of 93.0% and a specificity of 86.0%.The areas under the receiver operator characteristic curve,sensitivity,specificity,and positive and negative predictive values were 0.94,79.1%,90.8%,75.6%,and 92.3%,respectively(P<0.001).CONCLUSIONS:The ELF test is a promising non-invasive method for assessing liver fibrosis in patients with chronic hepatitis C.It is effective in the diagnosis of both fibrosis and cirrhosis. | Roberto Catanzaro Michele Milazzo Silvia Arona Chiara Sapienza Dario Vasta Domenico Arcoria Francesco Marotta | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，5： | 3 |
| 11 | Phase II clinical trial of phlebotomy for non‐alcoholic fatty liver disease显示文摘 | M. D. Beaton S. Chakrabarti M. Levstik M. Speechley P. Marotta P. Adams | 2013 | Aliment Pharmacol Ther2013，，7： | 3 |
| 12 | First description of cervical intradural thymoma metastasis显示文摘Thymoma and thymic carcinoma are rare epithelial tumors, which originate from the thymus gland. According to the World Health Organization there are 'organotypic'(types A, AB, B1, B2, and B3) and 'non-organotypic'(thymic carcinomas) thymomas. Type B3 thymomas are aggressive tumors, which can metastasize. Due to the rarity of these lesions, only 7 cases of extradural metastasis are described in the literature. We report the first and unique case of a man with cervical intradural B3 thymoma metastasis. A 46-year-old man underwent thymoma surgical removal. The year after the procedure he was treated for a parietal pleura metastasis. In 2006 he underwent cervical-dorsal extradural metastasis removal and C5-Th1 stabilization. Seven years after he came to our observation complaining left cervicobrachialgia and a reduction of strength of the left arm. He underwent a cervical spine magnetic resonance imaging, which showed a new lesion at the C5-C7 level. The patient underwent a surgery for the intradural B3 thymoma metastasis. Neurological symptoms improved although the removal was subtotal. He went through postoperative radiation therapy with further mass reduction. Spinal metastases are extremely rare. To date, only 7 cases of spinal extradural metastasis have been described in the literature. This is the first case of spinal intradural metastasis. Early individuation of these tumors and surgical treatment improve neurological outcome in patients with spinal cord compression. A multimodal treatment including neoadjuvant chemotherapy, surgery and postoperative radiation therapy seems to improve survival in patients with metastatic thymoma. | Nicola Marotta Cristina Mancarella Davide Colistra Alessandro Landi Demo Eugenio Dugoni Roberto Delfini | 2015 | World Journal of Clinical Cases2015，3，11： | 3 |
| 13 | Perioperative Neurological Complications After Liver Transplantation are Best Predicted by Pre-transplant Hepatic Encephalopathy显示文摘 | Rajat Dhar G. Bryan Young Paul Marotta | 2008 | Neurocritical Care2008，，2： | 3 |
| 14 | Bile duct hamartomas-the von Meyenburg complex显示文摘ABSTRACT: Hamartomas of the bile duct (von Meyenburg complex) are benign neoplasms of the liver, constituted histologically cystic dilatations of the bile duct, encompassed by fibrous stroma. We report a 42-year-old female patient with symptomatic cholecystitis, whose gross and ultrasonic appearance suggestive of multiple liver metastases. Magnetic resonance imaging and liver biopsy are the gold standards for diagnosis of this rare hepatobiliary condition. | Valdemir José Alegre Salles Alexandre Marotta Jorge Miguel Kather Netto Manlio Basílio Speranzini Marcos Roberto Martins | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，1： | 3 |
| 15 | Total tumor volume and alpha‐fetoprotein for selection of transplant candidates with hepatocellular carcinoma: A prospective validation显示文摘 | Christian Toso Glenda Meeberg Roberto Hernandez‐Alejandro Jean‐Fran?ois Dufour Paul Marotta Pietro Majno Norman M. Kneteman | 2015 | Hepatology2015，，1： | 2 |
| 16 | Permanent direct his bundle pacing does not induce ventricular dyssynchrony unlike conventional right ventricular apical pacing显示文摘 | Domenico Catanzariti Massimiliano Maines Claudio Cemin Gianpaolo Broso Tiziana Marotta Giuseppe Vergara | 2006 | Journal of Interventional Cardiac Electrophysiology2006，，2： | 2 |
| 17 | Hepatopulmonary syndrome and portopulmonary hypertension: A report of the multicenter liver transplant database显示文摘 | Michael J. Krowka M. Susan Mandell Michael A.E. Ramsay Steve M. Kawut Michael B. Fallon Cosme Manzarbeitia Manuel Pardo Paul Marotta Shinji Uemoto Markus P. Stoffel Joanne T. Benson | 2004 | Liver Transpl2004，，2： | 2 |
| 18 | Increased fecal viral content associated with obesity in mice显示文摘AIM: To investigate the presence of total gut viral content in obese mice, and establish correlation with obesity associated metabolic measures and gut microbiome.METHODS: Fresh fecal samples were collected from normal and obese(Leptin deficient Lep^(ob/ob)) mice. Total viral DNA and RNA was isolated and quantified for establishing the correlation with metabolic measures and composition of gut bacterial communities.RESULTS: In this report, we found that obese mice feces have higher viral contents in terms of total viral DNA and RNA(P < 0.001). Interestingly, these increased viral DNA and RNA content were tightly correlated with metabolic measures, i.e., body weight, fat mass and fasting blood glucose. Total viral content were positively correlated with firmicutes(R^2 > 0.6), whilst negatively correlated with bacteroidetes and bifidobacteria. CONCLUSION: This study suggests the strong correlation of increased viral population into the gut of obese mice and opens new avenues to explore the role of gut virome in pathophysiology of obesity. | Hariom Yadav Shalini Jain Ravinder Nagpal Francesco Marotta | 2016 | World Journal of Diabetes2016，7，15： | 2 |
| 19 | Lobular capillary hemangioma of the liver显示文摘BACKGROUND:Lobular capillary hemangioma(LCH) is a benign vascular tumor that is rare in adults and has never been reported in the liver.This vascular lesion usually presents on the skin or mucous membranes,and predominantly affects children. METHODS:LCH as a large asymptomatic hepatic mass was seen in a 35-year-old female.Imaging and pathologic characteristics of the mass are reviewed,and the relevant literature is also reviewed. RESULTS:A large vascular hepatic lesion was observed in an asymptomatic 35-year-old female.Pathologic examination after surgical resection revealed typical features of LCH. CONCLUSIONS:This is the first case of lobular capillary hemangioma seen as a liver lesion in an adult.Large vascular hepatic lesions pose significant difficulties in discerning benign from potentially malignant conditions.In this report we describe the pitfalls and radiological uncertainties with interpreting vascular lesions of the liver. | Faisal Abaalkhail Mathieu Castonguay David K.Driman Jeremy Parfitt Paul Marotta | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，3： | 2 |
| 20 | MR-Guided High-Intensity Focused Ultrasound: Current Status of an Emerging Technology显示文摘 | Alessandro Napoli Michele Anzidei Federica Ciolina Eugenio Marotta Beatrice Cavallo Marincola Giulia Brachetti Luisa Mare Gaia Cartocci Fabrizio Boni Vincenzo Noce Luca Bertaccini Carlo Catalano | 2013 | CardioVascular and Interventional Radiology2013，，5： | 2 |
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