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| 1 | What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?显示文摘Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middleto long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS? | Giovanni Tarantino Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,22: | 34 |
| 2 | What is the role of adiponectin in obesity related non-alcoholic fatty liver disease?显示文摘Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries.Insulin resistance is a key factor in the pathogenesis of NAFLD,the latter being considered as the hepatic component of insulin resistance or obesity.Adiponectin is the most abundant adipose-specific adipokine.There is evidence that adiponectin decreases hepatic and systematic insulin resistance,and attenuates liver inflammation and fibrosis.Adiponectin generally predicts steatosis grade and the severity of NAFLD;however,to what extent this is a direct effect or related to the presence of more severe insulin resistance or obesity remains to be addressed.Although there is no proven pharmacotherapy for the treatment of NAFLD,recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications.In this adiponectin-focused review,the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are analyzed systematically. | Carmine Finelli Giovanni Tarantino | 2013 | World Journal of Gastroenterology2013,19,6: | 29 |
| 3 | Drug-induced liver injury:Is it somehow foreseeable?显示文摘The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neosubstances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP. However, some susceptibility can today be predicted before drug administration, working on the common substrate, by phenotyping and genotyping studies and by taking in consideration patients' health status. Physicians should always think of this adverse effect in the absence of other clear hepatic disease. Ethical and legal problems towards operators in the health care system are always matters to consider. | Giovanni Tarantino Matteo Nicola Dario Di Minno Domenico Capone | 2009 | World Journal of Gastroenterology2009,15,23: | 30 |
| 4 | Hepatic steatosis,low-grade chronic inflammation and hormone/growth factor/adipokine imbalance显示文摘Non-alcoholic fatty liver disease (NAFLD), a further expression of metabolic syndrome, strictly linked to obesity and diabetes mellitus, is characterized by insulin resistance (IR), elevated serum levels of free fatty acids and fatty infi ltration of the liver, which is known as hepatic steatosis. Hepatocyte apoptosis is a key feature of this disease and correlates with its severity. Free-fatty-acidinduced toxicity represents one of mechanisms for the pathogenesis of NAFLD and hormones, growth factors and adipokines influence also play a key role. This review highlights the various pathways that contribute to the development of hepatic steatosis. Circulating concentrations of inflammatory cytokines are reckoned to be the most important factor in causing and maintaining IR. Low-grade chronic inflammation is fundamental in the progression of NAFLD toward higher risk cirrhotic states. | Giovanni Tarantino Silvia Savastano Annamaria Colao | 2010 | World Journal of Gastroenterology2010,16,38: | 22 |
| 5 | JNKs,insulin resistance and inflammation:A possible link between NAFLD and coronary artery disease显示文摘The incidence of obesity has dramatically increased in recent years.Consequently,obesity and associated disorders such as nonalcoholic fatty liver disease constitute a serious problem.Therefore,the contribution of adipose tissue to metabolic homeostasis has become a focus of interest.In this review,we discuss the latest discoveries that support the role of lipids in nonalcoholic fatty liver disease.We describe the common mechanisms(cJun aminoterminal kinases,endoplasmic reticulum stress,unfolded protein response,ceramide,lowgrade chronic inflammation)by which lipids and their derivatives impair insulin responsiveness and contribute to inflammatory liver and promote plaque instability in the arterial wall.Presenting the molecular mechanism of lipid activation of proinflammatory pathways,we attempt to find a link between nonalcoholic fatty liver disease,metabolic syndrome and cardiovascular diseases.Describing the common mechanisms by which lipid derivatives,through modulation of macrophage function,promote plaque instability in the arterial wall,impair insulin responsiveness and contribute to inflammatory liver and discussing the molecular mechanism of lipid activation of proinflammatory pathways,the key roles played by the proliferatoractivated receptor and liver X receptorα,nuclear receptorslipid sensors that link lipid metabolism and inflammation,should be emphasized.Further studies are warranted of antiinflammatory drugs such as aspirin,antiinterleukin6 receptors,immunemodulators(calcineurin inhibitors),substances enhancing the expression of heat shock proteins(which protect cells from endoplasmic reticulum stressinduced apoptosis),and anticJun aminoterminal kinases in welldesigned trials to try to minimize the high impact of these illnesses,and the different expressions of the diseases,on the whole population. | Giovanni Tarantino Armando Caputi | 2011 | World Journal of Gastroenterology2011,17,33: | 21 |
| 6 | Contrast-enhanced ultrasound in differentiating malignant from benign portal vein thrombosis in hepatocellular carcinoma显示文摘Portal vein thrombosis(PVT) may occur in liver cirrhosis patients. Malignant PVT is a common complication in cirrhotic patients with concomitant hepatocellular carcinoma(HCC) and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy. Gray-scale ultrasound(US) is widely unreliable for differentiating benign and malignant thrombi. Although effective for this differential diagnosis, fine-needle biopsy remains an invasive technique. Sensitivity of color-doppler US in detection of malignant thrombi is highly dependent on the size of the thrombus. Contrast-enhanced computed tomography(CT) and contrast-enhanced magnetic resonance(MRI) can be useful to assess the nature of portal thrombus, while limited data are currently available about the role of positron emission tomography(PET) and PET-CT. In contrast with CT, MRI, PET, and PET-CT, contrast-enhanced ultrasound(CEUS) is a fast, effective, well tolerated and cheap technique, that can be performed even in the same session in which the thrombus has been detected. CEUS can be performed bedside and can be available also in transplanted patients. Moreover, CT and MRI only yield a snapshot analysis during contrast diffusion, while CEUS allows for a continuous real-time imaging of the microcirculation that lasts several minutes, so that the whole arterial phase and the late parenchymal phase of the contrast diffusion can be analyzed continuously by real-time US scanning. Continuous real-time monitoring of contrast diffusion entails an easy detection of thrombus maximum enhancement. Moreover, continuous quantitative analyses of enhancement(wash in- wash out studies) by CEUS during contrast diffusion is nowadays available in most CEUS machines, thus giving a more sophisticated and accurate evaluation of the contrast distribution and an increased confidence in diagnosis in difficult cases. In conclusion, CEUS is avery reliable technique with a high intrinsic sensitivity for portal vein patency assessment. More expensive and sophisticated techniques(i.e., CT, MRI, PET, and PET-CT) should only be indicated in undetermined cases at CEUS. | Luciano Tarantino Pasquale Ambrosino Matteo Nicola Dario Di Minno | 2015 | World Journal of Gastroenterology2015,21,32: | 18 |
| 7 | Surgery in biliary lithiasis: from the traditional “open” approach to laparoscopy and the“rendezvous” technique显示文摘BACKGROUND:According to the current literature, biliary lithiasis is a worldwide-diffused condition that affects almost 20% of the general population. The rate of common bile duct stones(CBDS) in patients with symptomatic cholelithiasis is estimated to be 10% to 33%, depending on patient's age.Compared to stones in the gallbladder, the natural history of secondary CBDS is still not completely understood. It is not clear whether an asymptomatic choledocholithiasis requires treatment or not. For many years, open cholecystectomy with choledochotomy and/or surgical sphincterotomy and cleaning of the bile duct were the gold standard to treat both pathologies. Development of both endoscopic retrograde cholangiopancreatography(ERCP) and laparoscopic surgery,together with improvements in diagnostic procedures, influenced new approaches to the management of CBDS in association with gallstones.DATA SOURCES:We decided to systematically review the literature in order to identify all the current therapeutic options for CBDS. A systematic literature search was performed independently by two authors using Pub Med, EMBASE, Scopus and the Cochrane Library Central.RESULTS:The therapeutic approach nowadays varies greatly according to the availability of experience and expertise in each center, and includes open or laparoscopic common bile duct exploration, various combinations of laparoscopic cholecystectomy and ERCP and combined laparoendoscopic rendezvous.CONCLUSIONS:Although ERCP followed by laparoscopic cholecystectomy is currently preferred in the majority of hospitals worldwide, the optimal treatment for concomitant gallstones and CBDS is still under debate, and greatly varies among different centers. | Giuseppe Tarantino Paolo Magistri Roberto Ballarin Giacomo Assirati Antonio Di Cataldo Fabrizio Di Benedetto | 2017 | Hepatobiliary & Pancreatic Diseases International2017,16,6: | 18 |
| 8 | Pathogenesis of hepatic steatosis:The link between hypercortisolism and non-alcoholic fatty liver disease显示文摘Based on the available literature,non alcoholic fatty liver disease or generally speaking,hepatic steatosis,is more frequent among people with diabetes and obesity,and is almost universally present amongst morbidly obese diabetic patients.Non alcoholic fatty liver disease is being increasingly recognized as a common liver condition in the developed world,with non alcoholic steatohepatitis projected to be the leading cause of liver transplantation.Previous data report that only 20%of patients with Cushing’s syndrome have hepatic steatosis.Aiming at clarifying the reasons whereby patients suffering from Cushing’s syndrome-a condition characterized by profound metabolic changes-present low prevalence of hepatic steatosis,the Authors reviewed the current concepts on the link between hypercortisolism and obesity/metabolic syndrome.They hypothesize that this low prevalence of fat accumulation in the liver of patients with Cushing’s syndrome could result from the inhibition of the so-called low-grade chronicinflammation,mainly mediated by Interleukin 6,due to an excess of cortisol,a hormone characterized by an anti-inflammatory effect.The Cushing’s syndrome,speculatively considered as an in vivo model of the hepatic steatosis,could also help clarify the mechanisms of non alcoholic fatty liver disease. | Giovanni Tarantino Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,40: | 16 |
| 9 | Should nonalcoholic fatty liver disease be regarded as a hepatic illness only?显示文摘在一般人口的 2 糖尿病使在每天的最普通的诊断练习的不含酒精的脂肝疾病成为的肥胖和类型的高度增加的流行。生活方式变化(主要,锻练退却和重量增加) 可能提高了不含酒精的脂肝疾病的流行。在有不含酒精的脂肝疾病的病人的死亡显著地更高什么时候与一样的年龄性将军人口的相比。挑新负担的 Hepatologists 主张,不含酒精的脂肝疾病强烈正在被连接到系统病。 | Giovanni Tarantino | 2007 | World Journal of Gastroenterology2007,13,35: | 15 |
| 10 | Could metabolic syndrome lead to hepatocarcinoma via non-alcoholic fatty liver disease?显示文摘It was estimated that from 2002 to 2008 the risk of developing cancer increased a quarter-fold in men and twofold in women due to excessive BMI.Obesity,metabolic syndrome and type 2 diabetes mellitus are strictly related and are key pathogenetic factors of non-alcoholic fatty liver disease(NAFLD),the most frequent liver disease worldwide.The most important consequence of the'metabolic epidemics'is the probable rise in the incidence of hepatocarcinoma(HCC),and NAFLD is the major causative factor.Adipose tissue is not merely a storage organ where lipids are preserved as an energy source.It is an active organ with important endocrine,paracrine,and autocrine actions in addition to immune functions.Adipocytes produce a wide range of hormones,cytokines,and growth factors that can act locally in the adipose tissue microenvironment and systemically.In this article,the main roles of insulin growth factor(IGF)-1 and IGF-2 are discussed.The role of IGF-2 is not only confined to HCC,but it may also act in early hepato-carcinogenesis,as preneoplastic lesions express IGF-2 mRNA.IGF-1 and IGF-2interact with specific receptors(IGF-1R and IGF-2R).IGF-1R is over-expressed in in vitro and in animal models of HCC and it was demonstrated that IGF ligands exerted their effects on HCC cells through IGF-1R and that it was involved in the degeneration of pre-neoplastic lesions via an increase in their mitotic activity.Both IGF-2R and TGFβ,a growth inhibitor,levels are reduced in human HCC compared with adjacent normal liver tissues.Another key mechanism involves peroxisome proliferator-activated receptor(PPAR)γ.In in vitro studies,PPARγinhibited various carcinomas including HCC,most probably by regulating apoptosis via the p21,p53 and p27 pathways.Finally,as a clinical consequence,to improve survival,efforts to achieve a'healthier diet'should be promoted by physicians and politicians. | Antonella Scalerar Giovanni Tarantino | 2014 | World Journal of Gastroenterology2014,20,28: | 14 |
| 11 | 胰腺的液体集合的内视镜的指导超声的排水显示文摘 Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid collections include acute fluid collections, acute and chronic pancreatic pseudocysts, pancreatic abscesses and pancreatic necrosis. Before the introduction of linear endoscopic ultrasound (EUS) in the 1990s and the subsequent development of endoscopic ultrasound-guided drainage (EUS-GD) procedures, the available options for drainage in symptomatic PFCs included surgical drainage, percutaneous drainage using radiological guidance and conventional endoscopic transmural drainage. In recent years, it has gradually been recog-nized that, due to its lower morbidity rate compared to the surgical and percutaneous approaches, endoscopic treatment may be the preferred first-line approach for managing symptomatic PFCs. Endoscopic ultrasound-guided drainage has the following advantages, when compared to other alternatives such as surgical, per-cutaneous and non-EUS-guided endoscopic drainage.EUS-GD is less invasive than surgery and therefore does not require general anesthesia. The morbidity rate is lower, recovery is faster and the costs are lower. EUS-GD can avoid local complications related to per-cutaneous drainage. Because the endoscope is placed adjacent to the fluid collection, it can have direct ac-cess to the fluid cavity, unlike percutaneous drainage which traverses the abdominal wall. Complications such as bleeding, inadvertent puncture of adjacent viscera, secondary infection and prolonged periods of drainage with resultant pancreatico-cutaneous fistulae may be avoided. The only difference between EUS and non-EUS drainage is the initial step, namely, gaining access to the pancreatic fluid collection. All the sub-sequent steps are similar, i.e., insertion of guide-wires with fluoroscopic guidance, balloon dilatation of the cystogastrostomy and insertion of transmural stents or nasocystic catheters. With the introduction of the EUS-scope equipped with a large operative channel which permits drainage of the PFCs in 'one step', EUS-GD has been increasingly carried out in many tertiary care centers and has expanded the safety and efficacy of this modality, allowing access to and drainage of overly challenging fluid collections. However, the nature of the PFCs determines the outcome of this procedure. The technique and review of current literature regarding EUS-GD of PFCs will be discussed. | Carlo Fabbri Carmelo Luigiano Antonella Maimone Anna Maria Polifemo Ⅰlaria Tarantino Vincenzo Cennamo | 2012 | World Journal of Gastrointestinal Endoscopy2012,4,11: | 13 |
| 12 | Liver-spleen axis: Intersection between immunity, infections and metabolism显示文摘Spleen has been considered a neglected organ so far, even though is strictly linked to liver. The spleen plays an important role in the modulation of the immune system and in the maintenance of peripheral tolerance via the clearance of circulating apoptotic cells, the differentiation and activation of T and B cells and production of antibodies in the white pulp. Moreover, splenic macrophages are able to remove bacteria from the blood and protect from sepsis during systemic infections. We review the spleen function and its assessment in humans starting from the description of spleen diseases, ranging from the congenital asplenia to secondary hyposplenism. From the literature data it is clear that obesity in humans affects different compartments of immune system, even thought there are still few data available on the implicated mechamisms. The intent is to enable clinicians to evaluate the newly recognized role of metabolic and endocrine functions of the spleen with special emphasis to obesity and nonalcoholic fatty liver disease in the context of the available literature.Moreover, understanding the spleen function could be important to develop appropriate prevention strategies in order to counteract the pandemia of obesity. In this direction, we suggest spleen longitudinal diameter at ultrasonography, as simple, cheap and largely available tool, be used as new marker for assessing splenic function, in the context of the so-called liver-spleen axis. | Giovanni Tarantino Antonella Scalera Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,23: | 13 |
| 13 | Exposure to ambient air particulate matter and non-alcoholic fatty liver disease显示文摘The present study was designed to alert the public opinion and policy makers on the supposed enhancing effects of exposure to ambient air particulate matter with aerodynamic diameters < 2.5 mm (PM 2.5 ) on non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease in Western countries. For far too long literature data have been fixated on pulmonary diseases and/or cardiovascular disease, as consequence of particulate exposure, ignoring the link between the explosion of obesity with related syndromes such as NAFLD and air pollution, the worst characteristics of nowadays civilization. In order to delineate a clear picture of this major health problem, further studies should investigate whether and at what extent cigarette smoking and exposure to ambient air PM 2.5 impact the natural history of patients with obesity-related NAFLD,i.e. , development of non alcoholic steatohepatitis, disease characterized by a worse prognosis due its progression towards fibrosis and hepatocarcinoma. | Giovanni Tarantino Domenico Capone Carmine Finelli | 2013 | World Journal of Gastroenterology2013,19,25: | 11 |
| 14 | 含盐遗址重塑土的吸力测定及土水特征曲线拟合显示文摘在水、盐等多种因素的长期共同影响下,珍贵的交河故城本体普遍形成了表层结皮剥蚀病害,引发遗址不可逆转的破坏。非饱和土的特性与其吸力大小密切相关,因此准确确定土水特征曲线是深入研究土遗址劣化机理的基本前提。针对交河遗址土配制NaCl含量不同的泥浆,采用5种吸力测定方法(盐溶液蒸气平衡法、露点水势仪、滤纸法、压力膜仪和高容量张力计)获取被测土体干燥过程中的总吸力和基质吸力,开展不同方法所得吸力值之间的差异分析,借助van Genuchten(vG)和Fredlund & Xing(FX)两种模型拟合基质吸力的土水特征曲线。结果表明,NaCl对遗址土基质吸力几乎没有影响,但由于引发渗透吸力而使总吸力在高含水率段显著增大。不同吸力测定方法反映的遗址土持水特性大体相似;综合多组试验数据可降低曲线拟合误差,在全吸力范围内获得可靠的土水特征脱湿曲线。vG模型和FX模型的拟合效果都比较好,结果为进一步定量化分析土遗址表层结皮开裂病害的形成演变过程提供了科学依据。 | 张悦 叶为民 王琼 Alessandro Tarantino | 2019 | 岩土工程学报2019,41,9: | 11 |
| 15 | Serum Bcl-2 concentrations in overweight-obese subjects with nonalcoholic fatty liver disease显示文摘AIM: To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indices, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver (FL)and 41 with nonalcoholic steatohepatitis (NASH).METHODS: Circulating levels of Bcl-2 were detected in 84 patients with ultrasono graphic findings of 'bright liver' and/or hyper-transaminasemia of unknown origin and/or increase in γ-glutamyl-transpeptidase (γ-GT)strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups (43 with FL and 41 with NASH). Twenty lean subjects, apparently healthy and young, were chosen as controls.RESULTS: Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein (CRP) concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index (BMI) values (P ≤ 0.0001) but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males (P = 0.0008).γ-GT activity was associated with homeostatic metabolic assessment (HOMA) (P = 0.0003) and with serum ferritin (P = 0.02). Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients presented a weak negative correlation between lobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metaboli-cally unhealthy overweight/obese patients (MUOs) was evidenced. HOMA, BMI and uric acid, in that sequence,best predicted serum Bcl-2 concentrations.CONCLUSION: MUOs could be detected by Bcl-2 levels.By favoring the life span of hepatocytes, and enhancing triglyceride formation, the anti-apoptotic process inhibits free fatty acids toxicity in FL. | Giovanni Tarantino Francesco Scopacasa Annamaria Colao Domenico Capone Marianna Tarantino Ernesto Grimaldi Silvia Savastano | 2011 | World Journal of Gastroenterology2011,17,48: | 10 |
| 16 | Have guidelines addressing physical activity been established in nonalcoholic fatty liver disease?显示文摘The purpose of this review was to highlight, in relation to the currently accepted pathophysiology of non-alcoholic fatty liver disease (NAFLD), the known exercise habits of patients with NAFLD and to detail the benefits of lifestyle modification with exercise (and/or physical activity) on parameters of metabolic syndrome. More rigorous, controlled studies of longer duration and defined histopathological end-points comparing exercise alone and other treatment are needed before better, evidence-based physical activity modification guidelines can be established, since several questions remain unanswered. | Carmine Finelli Giovanni Tarantino | 2012 | World Journal of Gastroenterology2012,18,46: | 9 |
| 17 | Percutaneous electrochemotherapy in the treatment of portal vein tumor thrombosis at hepatic hilum in patients with hepatocellular carcinoma in cirrhosis: A feasibility study显示文摘AIM To treated with electrochemotherapy(ECT) a prospective case series of patients with liver cirrhosis and Vp3-Vp4- portal vein tumor thrombus(PVTT) from hepatocellular carcinoma(HCC), in order to evaluate the feasibility, safety and efficacy of this new non thermal ablative technique in those patients. METHODS Six patients(5 males and 1 female), aged 61-85 years(mean age, 70 years), four in Child-Pugh A and two in Child-Pugh B class, entered our study series. All patients were studied with three-phase computed tomography(CT), contrast enhanced ultrasound(CEUS) and ultrasound-guided percutaneous biopsy of the thrombus before ECT. All patients underwent ECT treatment(Cliniporator Vitae?, IGEA Sp A, Carpi, Modena, Italy) of Vp3-Vp4 PVTT in a single session. At the end of the procedure a post-treatment biopsy of the thrombus was performed. Scheduled follow-up in all patients entailed: CEUS within 24 h after treatment; triphasic contrastenhanced CT and CEUS at 3 mo after treatment and every six months thereafter.RESULTS Post-treatment CEUS showed complete absence of enhancement of the treated thrombus in all cases. Post-treatment biopsy showed apoptosis and necrosis of tumor cells in all cases. The follow-up ranged from 9 to 20 mo(median, 14 mo). In 2 patients, the followup CT and CEUS demonstrated complete patency of the treated portal vein. Other 3 patients showed a persistent avascular non-tumoral shrinked thrombus at CEUS and CT during follow-up. No local recurrence was observed at follow-up CT and CEUS in 5/6 patients. One patient was lost to follow-up because of death from gastrointestinal hemorrage 5 wk after ECT. CONCLUSION In patients with cirrhosis, ECT seems effective and safe for curative treatment of Vp3-Vp4 PVTT from HCC. | Luciano Tarantino Giuseppina Busto Aurelio Nasto Raffaele Fristachi Luigi Cacace Maria Talamo Catello Accardo Sara Bortone Paolo Gallo Paolo Tarantino Riccardo Aurelio Nasto Matteo Nicola Dario Di Minno Pasquale Ambrosino | 2017 | World Journal of Gastroenterology2017,23,5: | 7 |
| 18 | Endoscopic treatment of biliary complications after liver transplantation显示文摘AIM:To evaluate the efficacy of endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. METHODS:This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. RESULTS: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, 1 patient was re- transplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 ± 13.13 mo and 21.02 ± 14.10 mo, respectively.CONCLUSION: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results. | Ilaria Tarantino Luca Barresi Ioannis Petridis Riccardo Volpes Mario Traina Bruno Gridelli | 2008 | World Journal of Gastroenterology2008,14,26: | 6 |
| 19 | Could quantitative liver function tests gain wide acceptance among hepatologists?显示文摘It has been emphasized that the assessment of residual liver function is of paramount importance to determine the following: severity of acute or chronic liver diseases independent of etiology; long-term prognosis; step-by- step disease progression; surgical risk; and efflcacy of antiviral treatment. The most frequently used tools are the galactose elimination capacity to asses hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, and antipyrine clearance to estimate microsomal activity. However, a widely accepted liver test (not necessarily a laboratory one) to assess quantitative functional hepatic reserve still needs to be established, although there have been various proposals. Furthermore, who are the operators that should order these tests? Advances in analytic methods are expected to allow quantitative liver function tests to be used in clinical practice. | Giovanni Tarantino | 2009 | World Journal of Gastroenterology2009,15,28: | 6 |
| 20 | Hepatitis C virus lymphotropism and peculiar immunological phenotype:Effects on natural history and antiviral therapy显示文摘Hepatitis C virus(HCV) has been recognized to be both a hepato-and lymphotropic virus.HCV lymphotropism represents an essential lap in the pathogenesis of virusrelated autoimmune and lymphoproliferative disorders,ranging from clonal expansion of B-cells with organ-and non-organ-specific autoantibody production up to overt non-Hodgkin's lymphoma along a continuous step-by-step model of B-cell lymphomagenesis,where the intermediated mixed cryoglobulinemia could be considered as a stage of suppressible antigen-driven lymphoproliferation.HCV infection of lymphoid cells could set up privileged reservoirs able to interfere with the host viral clearance eff iciency and may be implicated in viral recurrence after apparently successful antiviral therapy.The HCV long-lasting extrahepatic replicative state generates an abnormal systemic immunological response,easily detectable by searching simple laboratory and clinical parameters,mainly represented by vasculitis-like skin features and hypocomplementemia.The presence or absence of this hypersensitivity pattern seems to correlate with the antiviral response and could be identif ied as a novel immunological cofactor.Further research is required to fully verify the real impact on therapeutic choice/regimen. | Paolo Conca Giovanni Tarantino | 2009 | World Journal of Gastroenterology2009,15,19: | 5 |